Intratracheal atomized surfactant provides similar outcomes as bolus surfactant in preterm lambs with respiratory distress syndrome

Ilaria Milesi, David G. Tingay, Emanuela Zannin, Federico Bianco, Paolo Tagliabue, Fabio Mosca, Anna Lavizzari, Maria Luisa Ventura, C. Elroy Zonneveld, Elizabeth J. Perkins, Don Black, Magdy Sourial, Raffaele L. Dellacá

Research output: Contribution to journalArticle

Abstract

Background:Aerosolization of exogenous surfactant remains a challenge. This study is aimed to evaluate the efficacy of atomized poractant alfa (Curosurf) administered with a novel atomizer in preterm lambs with respiratory distress syndrome.Methods:Twenty anaesthetized lambs, 127 ± 1 d gestational age, (mean ± SD) were instrumented before birth and randomized to receive either (i) positive pressure ventilation without surfactant (Control group), (ii) 200 mg/kg of bolus instilled surfactant (Bolus group) at 10 min of life or (iii) 200 mg/kg of atomized surfactant (Atomizer group) over 60 min from 10 min of life. All lambs were ventilated for 180 min with a standardized protocol. Lung mechanics, regional lung compliance (electrical impedance tomography), and carotid blood flow (CBF) were measured with arterial blood gas analysis.Results:Dynamic compliance and oxygenation responses were similar in the Bolus and Atomizer groups, and both better than Control by 180 min (all P <0.05; two-way ANOVA). Both surfactant groups demonstrated more homogeneous regional lung compliance throughout the study period. There were no differences in CBFConclusion:In a preterm lamb model, atomized surfactant resulted in similar gas exchange and mechanics as bolus administration. This study suggests evaluation of supraglottic atomization with this system when noninvasive support is warranted.

Original languageEnglish
Pages (from-to)92-100
Number of pages9
JournalPediatric Research
Volume80
Issue number1
DOIs
Publication statusPublished - Jul 1 2016

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ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Milesi, I., Tingay, D. G., Zannin, E., Bianco, F., Tagliabue, P., Mosca, F., Lavizzari, A., Ventura, M. L., Zonneveld, C. E., Perkins, E. J., Black, D., Sourial, M., & Dellacá, R. L. (2016). Intratracheal atomized surfactant provides similar outcomes as bolus surfactant in preterm lambs with respiratory distress syndrome. Pediatric Research, 80(1), 92-100. https://doi.org/10.1038/pr.2016.39