Nebulisation of surfactants in an animal model of neonatal respiratory distress.
OBJECTIVE
To evaluate pulmonary deposition and gas exchange following nebulisation of two surfactants by either a jet or an ultrasonic nebuliser.


METHODS
After bronchoalveolar lavage (BAL), 19 rabbits were ventilated in four groups. Group A1 (n = 5) and A2 (n = 6) received Technetium-99m labelled Exosurf, and groups B1 (n = 4) and B2 (n = 4) received radiolabelled Survanta. Groups A1 and B1 received jet nebuliser therapy, whereas groups A2 and B2 received ultrasonic nebuliser. Pulmonary deposition, distribution, and blood gases were determined.


RESULTS
Pulmonary deposition as per cent of initial dose and mg lipid) was 0.28(0.10)% or 0.59(0.21) mg in group A1, 1.05(0.23)% or 2.21(0.48) mg in group A2, 0.08(0.02)% or 0.30(0.08) mg in group B1, and 0.09(0.02)% or 0.34(0.08) mg in group B2. Deposition in group A2 was greater than in other groups (p = 0.001). Group A2 showed a small improvement in blood gases.


CONCLUSIONS
Even the highest deposition--ultrasonic nebuliser with Exosurf--achieved limited clinical effect. The aerosol route is currently not effective for surfactant treatment.
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Department of Paediatrics, McMaster University Medical Centre, Hamilton, Ontario, Canada.
al-Essa
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Dolovich
M
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Rasid
F
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Kirpalani
H
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D000336:Aerosols; D000818:Animals; D001688:Biological Products; D002245:Carbon Dioxide / Q000097:blood; D004195:Disease Models, Animal; D004338:Drug Combinations; D005233:Fatty Alcohols / Q000008:administration & dosage / Q000493:pharmacokinetics; D006801:Humans; D007231:Infant, Newborn; D008168:Lung / Q000378:metabolism; D009330:Nebulizers and Vaporizers; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D010767:Phosphorylcholine; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000493:pharmacokinetics; D011663:Pulmonary Surfactants / Q000008:administration & dosage* / Q000493:pharmacokinetics; D011817:Rabbits; D012127:Respiratory Distress Syndrome, Newborn / Q000378:metabolism / Q000628:therapy*
D000336:Aerosols; D001688:Biological Products; D004338:Drug Combinations; D005233:Fatty Alcohols; D011663:Pulmonary Surfactants; D010767:Phosphorylcholine; D002245:Carbon Dioxide; D011092:Polyethylene Glycols; C047049:dipalmitoylphosphatidylcholine, hexadecanol, tyloxapol drug combination; C072197:beractant; D010100:Oxygen