title: Intrapulmonary drug administration in neonatal and paediatric critical care: a comprehensive review.
abstract: Administration of drugs directly into the respiratory tree first was proposed a long time ago. Surfactant is the paradigmatic example of such therapies. Many other drugs have been used in the same way and further compounds are under investigation for this aim. In the last two decades, despite the wide number of drugs available for direct lung administration in critical care patients, few controlled data exist regarding their use in neonates and infants. This review will focus on drugs clinically available in a critical care setting for neonates and infants, including bronchodilators, pulmonary vasodilators, anti-inflammatory agents, mucolytics, resuscitative anti-infective agents, surfactants and other drugs. We provide an evidence-based comprehensive review of drugs available for intratracheal administration in paediatric and neonatal critical care and we examine possible advantages and risks for each proposed indication.
authors.affiliation: Neonatal Intensive Care Unit, Women and Children's Hospital G.Salesi, Polytechnical University of Marche, Ancona, Italy. dm.deluca@fastwebnet.it
authors.forename: D
authors.initials: D
authors.lastname: De Luca
authors.forename: P
authors.initials: P
authors.lastname: Cogo
authors.forename: E
authors.initials: E
authors.lastname: Zecca
authors.forename: M
authors.initials: M
authors.lastname: Piastra
authors.forename: D
authors.initials: D
authors.lastname: Pietrini
authors.forename: A
authors.initials: A
authors.lastname: Tridente
authors.forename: G
authors.initials: G
authors.lastname: Conti
authors.forename: V P
authors.initials: VP
authors.lastname: Carnielli
mesh_terms: D000280:Administration, Inhalation; D058666:Adrenergic beta-2 Receptor Agonists / Q000378:metabolism; D001993:Bronchodilator Agents / Q000494:pharmacology; D002648:Child; D018680:Cholinergic Antagonists / Q000378:metabolism; D003422:Critical Care / Q000379:methods; D004837:Epinephrine / Q000378:metabolism; D019317:Evidence-Based Medicine / Q000379:methods; D005740:Gases; D006801:Humans; D015931:Intensive Care, Neonatal / Q000379:methods; D009569:Nitric Oxide / Q000378:metabolism; D044062:Prostaglandins I / Q000378:metabolism; D012137:Respiratory System / Q000473:pathology*; D026403:S-Nitrosothiols / Q000737:chemistry; D013256:Steroids / Q000737:chemistry; D013501:Surface-Active Agents / Q000494:pharmacology
chemical_list: D058666:Adrenergic beta-2 Receptor Agonists; D001993:Bronchodilator Agents; D018680:Cholinergic Antagonists; D005740:Gases; D044062:Prostaglandins I; D026403:S-Nitrosothiols; D013256:Steroids; D013501:Surface-Active Agents; D009569:Nitric Oxide; D004837:Epinephrine