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Nebulization of High-Dose Poractant Alfa in Newborn Piglets on Nasal Continuous Positive Airway Pressure Yields Therapeutic Lung Doses of Phospholipids
- Source :
- American Journal of Perinatology. 39:1001-1007
- Publication Year :
- 2020
- Publisher :
- Georg Thieme Verlag KG, 2020.
-
Abstract
- Objective: It is not known how much surfactant must be nebulized to reach a lung dose of phospholipids equivalent to that obtained by the instillation of 200 mg/kg of surfactant. We aimed to assess the feasibility of nebulizing a high-dose of poractant alfa with the eFlow-Neos investigational vibrating-membrane nebulizer in newborn piglets on nasal continuous positive airway pressure (nCPAP) and to determine whether this intervention would yield therapeutic lung doses of phospholipids. Study Design: Twelve 1-day-old piglets on nCPAP received 600 mg/kg of poractant alfa admixed with technetium-99m via nebulization. Six piglets receiving 200 mg/kg of instilled synthetic surfactant served as controls. Lung deposition (percentage of the nominal dose) was determined by gamma scintigraphy, and the phospholipids' lung dose was calculated. Results: The lung dose of phospholipids (mean ± standard deviation [SD]) was 138 ± 96 mg/kg with nebulization, and 172 ± 24 mg/kg with instillation (p = 0.42). Nebulization took 58 ± 12 minutes. The arterial partial pressure of carbon dioxide increased from 6.7 ± 1.1 to 7.2 ± 1.1 kPa during nebulization (p = 0.04). Cerebral oximetry remained stable, and there was no hemodynamic instability. Conclusion: Nebulization was well tolerated, and the mean lung dose of phospholipids was above 100 mg/kg, that is, not different from the instillation group. These experimental findings suggest that it may be feasible to reach therapeutic lung doses of phospholipids by surfactant nebulization during nCPAP. Key Points It is not known if effective lung doses of surfactant can be delivered by nebulization. Nebulization of high-dose surfactant in newborn piglets on nCPAP was well tolerated. A high-dose of nebulized poractant alfa yielded therapeutic lung doses of phospholipids. (Less)
- Subjects :
- Neonatal respiratory distress syndrome
Swine
medicine.medical_treatment
Surface-Active Agents
03 medical and health sciences
0302 clinical medicine
Pulmonary surfactant
030225 pediatrics
medicine
Animals
Humans
Poractant alfa
Oximetry
030212 general & internal medicine
Continuous positive airway pressure
Lung
Phospholipids
Aerosolization
Biological Products
Respiratory Distress Syndrome, Newborn
Continuous Positive Airway Pressure
Mean lung dose
business.industry
Infant, Newborn
Obstetrics and Gynecology
Pulmonary Surfactants
medicine.disease
Nebulizer
medicine.anatomical_structure
Animals, Newborn
Cerebrovascular Circulation
Anesthesia
Pediatrics, Perinatology and Child Health
business
medicine.drug
Subjects
Details
- ISSN :
- 10988785 and 07351631
- Volume :
- 39
- Database :
- OpenAIRE
- Journal :
- American Journal of Perinatology
- Accession number :
- edsair.doi.dedup.....e1425b5f8da832874e6e1a0d7d96a1f8