Continuous positive airway pressure and surfactant; combined data from animal experiments and clinical trials.
Bronchopulmonary dysplasia (BPD) remains a cause of considerable morbidity for the preterm infant. Ventilation is a primary risk factor. This review discusses the rationale for combining surfactant and nasal continuous positive airway pressure (nCPAP) using evidence from both clinical and animal studies. The early application of nCPAP with or without surfactant is safe and reduces the need for mechanical ventilation. Combining nCPAP with surfactant results in dramatically improved lung structure in a primate model of BPD, but still does not allow for normal alveolarization. BPD is a complex condition resulting from the interaction of many factors. Experimental evaluation of nCPAP in appropriate animal models will allow new strategies for prevention and treatment of BPD to be developed.
Thomson
Merran A
MA
Department of Paediatrics and Neonatal Medicine, Queen Charlotte's and Chelsea Hospital at the Hammersmith Hospital, London, UK. merran.thomson@ic.ac.uk
D000818:Animals; D000831:Animals, Newborn; D001997:Bronchopulmonary Dysplasia / Q000517:prevention & control* / Q000628:therapy*; D002986:Clinical Trials as Topic; D006801:Humans; D007231:Infant, Newborn; D009296:Nasal Cavity; D011175:Positive-Pressure Respiration; D011663:Pulmonary Surfactants / Q000172:deficiency / Q000627:therapeutic use*; D012121:Respiration, Artificial; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy
D011663:Pulmonary Surfactants