Ilaria Milesi1, David G Tingay2,3,4, Emanuela Zannin1, Federico Bianco5, Paolo Tagliabue6, Fabio Mosca7, Anna Lavizzari7, Maria Luisa Ventura6, C Elroy Zonneveld2, Elizabeth J Perkins2, Don Black2, Magdy Sourial2, Raffaele L Dellacá1. 1. Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano University, Milano, Italy. 2. Neonatal Research, Murdoch Childrens Research Institute, Melbourne, Australia. 3. Neonatology, The Royal Children's Hospital, Parkville, Australia. 4. Department of Paediatrics, University of Melbourne, Melbourne, Australia. 5. Research and Development Department, Chiesi Farmaceutici SpA, Parma, Italy. 6. Neonatal Intensive Care Unit, Fondazione MBBM, Monza, Italy. 7. NICU, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico-Università degli Studi di Milano.
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 CBF Conclusion: 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.
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 CBF Conclusion: 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.
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Authors: Timothy P Stevens; Neil N Finer; Waldemar A Carlo; Peter G Szilagyi; Dale L Phelps; Michele C Walsh; Marie G Gantz; Abbot R Laptook; Bradley A Yoder; Roger G Faix; Jamie E Newman; Abhik Das; Barbara T Do; Kurt Schibler; Wade Rich; Nancy S Newman; Richard A Ehrenkranz; Myriam Peralta-Carcelen; Betty R Vohr; Deanne E Wilson-Costello; Kimberly Yolton; Roy J Heyne; Patricia W Evans; Yvonne E Vaucher; Ira Adams-Chapman; Elisabeth C McGowan; Anna Bodnar; Athina Pappas; Susan R Hintz; Michael J Acarregui; Janell Fuller; Ricki F Goldstein; Charles R Bauer; T Michael O'Shea; Gary J Myers; Rosemary D Higgins Journal: J Pediatr Date: 2014-04-13 Impact factor: 4.406
Authors: Graeme R Polglase; David G Tingay; Risha Bhatia; Clare A Berry; Robert J Kopotic; Clinton P Kopotic; Yong Song; Edgardo Szyld; Alan H Jobe; Jane J Pillow Journal: BMC Pediatr Date: 2014-02-15 Impact factor: 2.125
Authors: Prue M Pereira-Fantini; Sean G Byars; Karen E McCall; Elizabeth J Perkins; Regina B Oakley; R L Dellacà; Peter A Dargaville; Peter G Davis; Vera Ignjatovic; David G Tingay Journal: Sci Rep Date: 2018-08-22 Impact factor: 4.379
Authors: Federico Bianco; Fabrizio Salomone; Ilaria Milesi; Xabier Murgia; Sauro Bonelli; Elena Pasini; Raffaele Dellacà; Maria Luisa Ventura; Jane Pillow Journal: Respir Res Date: 2021-02-26
Authors: Regina B Oakley; David G Tingay; Karen E McCall; Elizabeth J Perkins; Magdy Sourial; Peter A Dargaville; Prue M Pereira-Fantini Journal: Front Pediatr Date: 2019-08-21 Impact factor: 3.418