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A novel delivery system for supraglottic atomization allows increased lung deposition rates of pulmonary surfactant in newborn piglets

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 (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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author
; ; ; ; ; ; ; and
organization
publishing date
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 &lt; 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}},
}