A novel delivery system for supraglottic atomization allows increased lung deposition rates of pulmonary surfactant in newborn piglets
(2020) In Pediatric Research 87(6). p.1019-1024- Abstract
- Background: Earlier attempts to deliver effective lung doses of surfactant by aerosolization were unsuccessful, mostly because of technical shortcomings. We aimed at quantifying the lung deposition of poractant alfa with a new supraglottic delivery system for surfactant atomization in an experimental neonatal model.
Methods: The method involved six sedated 1-day-old piglets lying in the lateral decubitus, spontaneously breathing on nasal-mask continuous positive airway pressure (nCPAP). A pharyngeal cannula housing a multi-channel air-blasting atomization catheter was placed through the mouth with its tip above the glottis entrance. In all, 200 mg kg-1 of a 99mTc-surfactant mixture was atomized through the catheter synchronously with... (More) - Background: Earlier attempts to deliver effective lung doses of surfactant by aerosolization were unsuccessful, mostly because of technical shortcomings. We aimed at quantifying the lung deposition of poractant alfa with a new supraglottic delivery system for surfactant atomization in an experimental neonatal model.
Methods: The method involved six sedated 1-day-old piglets lying in the lateral decubitus, spontaneously breathing on nasal-mask continuous positive airway pressure (nCPAP). A pharyngeal cannula housing a multi-channel air-blasting atomization catheter was placed through the mouth with its tip above the glottis entrance. In all, 200 mg kg-1 of a 99mTc-surfactant mixture was atomized through the catheter synchronously with inspiration. Six intubated control piglets received an equal amount of intratracheally instilled 99mTc-surfactant mixture. The percentage of the 99mTc-surfactant mixture deposited in the lungs was estimated by scintigraphy.
Results: Median (range) deposition in the lungs was 40% (24-68%) after atomization and 87% (55-95%) after instillation (p < 0.001). Overall, almost 80% of the deposited surfactant was in the dependent lung. Effective atomization time (atomizer on) was 28 (17-52) min, yielding an output rate of 0.1-0.2 mL min-1.
Conclusions: Without endotracheal intubation, in spontaneously breathing newborn piglets, this new supraglottic atomizer delivery system attained a median lung deposition of 40% of the nominal dose of surfactant. (Less)
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https://lup.lub.lu.se/record/ec7762fb-04d2-47e3-b51c-4ddf4b1dff96
- author
- Nord, Anders LU ; Linnér, Rikard LU ; Milesi, Ilaria ; Zannin, Emanuela ; di Castri, Marco ; Bianco, Federico ; Dellaca, Raffaele.L ; Cunha Goncalves, Doris LU and Perez de Sá, Valéria LU
- organization
- publishing date
- 2020
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Pediatric Research
- volume
- 87
- issue
- 6
- pages
- 1019 - 1024
- publisher
- International Pediatric Foundation Inc.
- external identifiers
-
- pmid:31785590
- scopus:85075921877
- ISSN
- 1530-0447
- DOI
- 10.1038/s41390-019-0696-x
- language
- English
- LU publication?
- yes
- id
- ec7762fb-04d2-47e3-b51c-4ddf4b1dff96
- date added to LUP
- 2021-04-26 16:36:25
- date last changed
- 2022-04-27 01:41:26
@article{ec7762fb-04d2-47e3-b51c-4ddf4b1dff96, abstract = {{Background: Earlier attempts to deliver effective lung doses of surfactant by aerosolization were unsuccessful, mostly because of technical shortcomings. We aimed at quantifying the lung deposition of poractant alfa with a new supraglottic delivery system for surfactant atomization in an experimental neonatal model.<br> Methods: The method involved six sedated 1-day-old piglets lying in the lateral decubitus, spontaneously breathing on nasal-mask continuous positive airway pressure (nCPAP). A pharyngeal cannula housing a multi-channel air-blasting atomization catheter was placed through the mouth with its tip above the glottis entrance. In all, 200 mg kg-1 of a 99mTc-surfactant mixture was atomized through the catheter synchronously with inspiration. Six intubated control piglets received an equal amount of intratracheally instilled 99mTc-surfactant mixture. The percentage of the 99mTc-surfactant mixture deposited in the lungs was estimated by scintigraphy.<br> Results: Median (range) deposition in the lungs was 40% (24-68%) after atomization and 87% (55-95%) after instillation (p < 0.001). Overall, almost 80% of the deposited surfactant was in the dependent lung. Effective atomization time (atomizer on) was 28 (17-52) min, yielding an output rate of 0.1-0.2 mL min-1.<br> Conclusions: Without endotracheal intubation, in spontaneously breathing newborn piglets, this new supraglottic atomizer delivery system attained a median lung deposition of 40% of the nominal dose of surfactant.}}, author = {{Nord, Anders and Linnér, Rikard and Milesi, Ilaria and Zannin, Emanuela and di Castri, Marco and Bianco, Federico and Dellaca, Raffaele.L and Cunha Goncalves, Doris and Perez de Sá, Valéria}}, issn = {{1530-0447}}, language = {{eng}}, number = {{6}}, pages = {{1019--1024}}, publisher = {{International Pediatric Foundation Inc.}}, series = {{Pediatric Research}}, title = {{A novel delivery system for supraglottic atomization allows increased lung deposition rates of pulmonary surfactant in newborn piglets}}, url = {{http://dx.doi.org/10.1038/s41390-019-0696-x}}, doi = {{10.1038/s41390-019-0696-x}}, volume = {{87}}, year = {{2020}}, }