Nebulization of Poractant alfa via a vibrating membrane nebulizer in spontaneously breathing preterm lambs with binasal continuous positive pressure ventilation

Matthias C. Hütten, Elke Kuypers, Daan R Ophelders, Maria Nikiforou, Reint K Jellema, Hendrik J Niemarkt, Carola Fuchs, Markus Tservistas, Roberta Razetti, Federico Bianco, Boris W Kramer

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)

Abstract

BACKGROUND: Surfactant replacement therapy is the gold standard treatment of neonatal respiratory distress (RDS). Nebulization is a noninvasive mode of surfactant administration. We administered Poractant alfa (Curosurf) via a vibrating perforated membrane nebulizer (eFlow Neonatal Nebulizer) to spontaneously breathing preterm lambs during binasal continuous positive pressure ventilation (CPAP).

METHODS: Sixteen preterm lambs were operatively delivered at a gestational age of 133 ± 1 d (term ~150 d), and connected to CPAP applied via customized nasal prongs. Nebulization was performed (i) with saline or (ii) with surfactant for 3 h in humidified or (iii) nonhumidified air, and with surfactant (iv) for 60 min or (v) for 30 min. We measured arterial oxygenation, lung gas volumes and surfactant pool size and deposition.

RESULTS: Nebulization of surfactant in humidified air for 3 h improved oxygenation and lung function, and surfactant was preferentially distributed to the lower lung lobes. Shorter nebulization times and 3 h nebulization in dry air did not show these effects. Nebulized surfactant reached all lung lobes, however the increase of surfactant pool size missed statistical significance.

CONCLUSION: Positive effects of surfactant nebulization to spontaneously breathing preterm lambs depend on treatment duration, surfactant dose, air humidity, and surfactant distribution within the lung.

Original languageEnglish
Pages (from-to)664-9
Number of pages6
JournalPediatric Research
Volume78
Issue number6
DOIs
Publication statusPublished - Dec 2015

Keywords

  • Administration, Inhalation
  • Animals
  • Animals, Newborn
  • Biological Products
  • Continuous Positive Airway Pressure
  • Disease Models, Animal
  • Equipment Design
  • Gestational Age
  • Lung
  • Membranes, Artificial
  • Nebulizers and Vaporizers
  • Phospholipids
  • Premature Birth
  • Pulmonary Surfactants
  • Respiration
  • Respiratory Distress Syndrome, Newborn
  • Sheep
  • Time Factors
  • Vibration

Cite this

Hütten, Matthias C. ; Kuypers, Elke ; Ophelders, Daan R ; Nikiforou, Maria ; Jellema, Reint K ; Niemarkt, Hendrik J ; Fuchs, Carola ; Tservistas, Markus ; Razetti, Roberta ; Bianco, Federico ; Kramer, Boris W. / Nebulization of Poractant alfa via a vibrating membrane nebulizer in spontaneously breathing preterm lambs with binasal continuous positive pressure ventilation. In: Pediatric Research. 2015 ; Vol. 78, No. 6. pp. 664-9.
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abstract = "BACKGROUND: Surfactant replacement therapy is the gold standard treatment of neonatal respiratory distress (RDS). Nebulization is a noninvasive mode of surfactant administration. We administered Poractant alfa (Curosurf) via a vibrating perforated membrane nebulizer (eFlow Neonatal Nebulizer) to spontaneously breathing preterm lambs during binasal continuous positive pressure ventilation (CPAP).METHODS: Sixteen preterm lambs were operatively delivered at a gestational age of 133 ± 1 d (term ~150 d), and connected to CPAP applied via customized nasal prongs. Nebulization was performed (i) with saline or (ii) with surfactant for 3 h in humidified or (iii) nonhumidified air, and with surfactant (iv) for 60 min or (v) for 30 min. We measured arterial oxygenation, lung gas volumes and surfactant pool size and deposition.RESULTS: Nebulization of surfactant in humidified air for 3 h improved oxygenation and lung function, and surfactant was preferentially distributed to the lower lung lobes. Shorter nebulization times and 3 h nebulization in dry air did not show these effects. Nebulized surfactant reached all lung lobes, however the increase of surfactant pool size missed statistical significance.CONCLUSION: Positive effects of surfactant nebulization to spontaneously breathing preterm lambs depend on treatment duration, surfactant dose, air humidity, and surfactant distribution within the lung.",
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Nebulization of Poractant alfa via a vibrating membrane nebulizer in spontaneously breathing preterm lambs with binasal continuous positive pressure ventilation. / Hütten, Matthias C.; Kuypers, Elke; Ophelders, Daan R; Nikiforou, Maria; Jellema, Reint K; Niemarkt, Hendrik J; Fuchs, Carola; Tservistas, Markus; Razetti, Roberta; Bianco, Federico; Kramer, Boris W.

In: Pediatric Research, Vol. 78, No. 6, 12.2015, p. 664-9.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Nebulization of Poractant alfa via a vibrating membrane nebulizer in spontaneously breathing preterm lambs with binasal continuous positive pressure ventilation

AU - Hütten, Matthias C.

AU - Kuypers, Elke

AU - Ophelders, Daan R

AU - Nikiforou, Maria

AU - Jellema, Reint K

AU - Niemarkt, Hendrik J

AU - Fuchs, Carola

AU - Tservistas, Markus

AU - Razetti, Roberta

AU - Bianco, Federico

AU - Kramer, Boris W

PY - 2015/12

Y1 - 2015/12

N2 - BACKGROUND: Surfactant replacement therapy is the gold standard treatment of neonatal respiratory distress (RDS). Nebulization is a noninvasive mode of surfactant administration. We administered Poractant alfa (Curosurf) via a vibrating perforated membrane nebulizer (eFlow Neonatal Nebulizer) to spontaneously breathing preterm lambs during binasal continuous positive pressure ventilation (CPAP).METHODS: Sixteen preterm lambs were operatively delivered at a gestational age of 133 ± 1 d (term ~150 d), and connected to CPAP applied via customized nasal prongs. Nebulization was performed (i) with saline or (ii) with surfactant for 3 h in humidified or (iii) nonhumidified air, and with surfactant (iv) for 60 min or (v) for 30 min. We measured arterial oxygenation, lung gas volumes and surfactant pool size and deposition.RESULTS: Nebulization of surfactant in humidified air for 3 h improved oxygenation and lung function, and surfactant was preferentially distributed to the lower lung lobes. Shorter nebulization times and 3 h nebulization in dry air did not show these effects. Nebulized surfactant reached all lung lobes, however the increase of surfactant pool size missed statistical significance.CONCLUSION: Positive effects of surfactant nebulization to spontaneously breathing preterm lambs depend on treatment duration, surfactant dose, air humidity, and surfactant distribution within the lung.

AB - BACKGROUND: Surfactant replacement therapy is the gold standard treatment of neonatal respiratory distress (RDS). Nebulization is a noninvasive mode of surfactant administration. We administered Poractant alfa (Curosurf) via a vibrating perforated membrane nebulizer (eFlow Neonatal Nebulizer) to spontaneously breathing preterm lambs during binasal continuous positive pressure ventilation (CPAP).METHODS: Sixteen preterm lambs were operatively delivered at a gestational age of 133 ± 1 d (term ~150 d), and connected to CPAP applied via customized nasal prongs. Nebulization was performed (i) with saline or (ii) with surfactant for 3 h in humidified or (iii) nonhumidified air, and with surfactant (iv) for 60 min or (v) for 30 min. We measured arterial oxygenation, lung gas volumes and surfactant pool size and deposition.RESULTS: Nebulization of surfactant in humidified air for 3 h improved oxygenation and lung function, and surfactant was preferentially distributed to the lower lung lobes. Shorter nebulization times and 3 h nebulization in dry air did not show these effects. Nebulized surfactant reached all lung lobes, however the increase of surfactant pool size missed statistical significance.CONCLUSION: Positive effects of surfactant nebulization to spontaneously breathing preterm lambs depend on treatment duration, surfactant dose, air humidity, and surfactant distribution within the lung.

KW - Administration, Inhalation

KW - Animals

KW - Animals, Newborn

KW - Biological Products

KW - Continuous Positive Airway Pressure

KW - Disease Models, Animal

KW - Equipment Design

KW - Gestational Age

KW - Lung

KW - Membranes, Artificial

KW - Nebulizers and Vaporizers

KW - Phospholipids

KW - Premature Birth

KW - Pulmonary Surfactants

KW - Respiration

KW - Respiratory Distress Syndrome, Newborn

KW - Sheep

KW - Time Factors

KW - Vibration

U2 - 10.1038/pr.2015.165

DO - 10.1038/pr.2015.165

M3 - Article

C2 - 26322413

VL - 78

SP - 664

EP - 669

JO - Pediatric Research

JF - Pediatric Research

SN - 0031-3998

IS - 6

ER -