Physiologic Effects of Instilled and Aerosolized Surfactant Using a Breath-Synchronized Nebulizer on Surfactant-Deficient Rabbits
Surfactant administration incorporates liquid bolus instillation via endotracheal tube catheter and use of a mechanical ventilator. Aerosolized surfactant has generated interest and conflicting data related to dose requirements and efficacy. We hypothesized that aerosolized surfactant with a novel b...
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| Main Authors: | , , , , , |
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| Format: | Book |
| Published: |
MDPI AG,
2021-09-01T00:00:00Z.
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| Online Access: | Connect to this object online. |
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| Summary: | Surfactant administration incorporates liquid bolus instillation via endotracheal tube catheter and use of a mechanical ventilator. Aerosolized surfactant has generated interest and conflicting data related to dose requirements and efficacy. We hypothesized that aerosolized surfactant with a novel breath-actuated vibrating mesh nebulizer would have similar efficacy and safety as instilled surfactant. Juvenile rabbits (1.50 ± 0.20 kg, <i>n</i> = 17) were sedated, anesthetized, intubated, and surfactant was depleted via lung lavage on mechanical ventilation. Subjects were randomized to receive standard dose liquid instillation via catheter (<i>n</i> = 5); low dose surfactant (<i>n</i> = 5) and standard dose surfactant (<i>n</i> = 5) via aerosol; and descriptive controls (no treatment, <i>n</i> = 2). Peridosing events, disease severity and gas exchange, were recorded every 30 min for 3 h following surfactant administration. Direct-Instillation group had higher incidence for peridosing events than aerosol. Standard dose liquid and aerosol groups had greater PaO<sub>2</sub> from pre-treatment baseline following surfactant (<i>p</i> < 0.05) with greater ventilation efficiency with aerosol (<i>p</i> < 0.05). Our study showed similar improvement in oxygenation response with greater ventilation efficiency with aerosol than liquid bolus administration at the same dose with fewer peridosing events. Breath-synchronized aerosol via nebulizer has potential as a safe, effective, and economical alternative to bolus liquid surfactant instillation. |
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| Item Description: | 10.3390/pharmaceutics13101580 1999-4923 |