title: Aerosolized surfactants.
abstract: OBJECTIVE
  To present existing data on the potential use of aerosolized surfactants for treatment of neonatal respiratory distress syndrome in the era of noninvasive ventilatory support.
  
  
  RESULTS
  Current surfactant therapy requires endotracheal intubation and application of positive pressure ventilation. Instillation of the drug itself can be complicated by 'peridosing adverse events' including, but not limited to, desaturations, bradycardias, changes in blood pressure, drug reflux and even the need for reintubations. Increasing use of noninvasive ventilatory support for neonatal respiratory distress syndrome has motivated clinicians and researchers to look for alternate ways of introducing surfactants to patients. Aerosolized surfactants have been tested in animal models of respiratory distress syndrome. In addition, four small clinical studies have been performed to date. The effectiveness of this form of treatment requires further study, however, which will need to include optimizing the dose of aerosolized surfactant, choosing particle size, developing the best delivery system, and using a surfactant formulation that maintains its activity once aerosolized.
  
  
  CONCLUSIONS
  Aerosolized surfactants for neonatal respiratory distress syndrome may prevent the need for endotracheal intubation. Appropriately designed randomized controlled studies are required to determine if this form of surfactant administration is as effective and safe as tracheal instillation.
authors.affiliation: Poznan University of Medical Sciences, Poland. janco@pol-med.com.pl
authors.forename: Jan
authors.initials: J
authors.lastname: Mazela
authors.forename: T Allen
authors.initials: TA
authors.lastname: Merritt
authors.forename: Neil N
authors.initials: NN
authors.lastname: Finer
mesh_terms: D000280:Administration, Inhalation; D000336:Aerosols; D000818:Animals; D045422:Continuous Positive Airway Pressure; D006801:Humans; D007231:Infant, Newborn; D011663:Pulmonary Surfactants / Q000008:administration & dosage*; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D000336:Aerosols; D011663:Pulmonary Surfactants