Comparison of three dosing procedures for administration of bovine surfactant to neonates with respiratory distress syndrome

Zola, Elizabeth M.; Gunkel, J. Harry; Chan, Raymond K. H.; Lim, Mary O.; Knox, Isabella; Feldman, Bernard H.; Denson, Susan E.; Stonestreet, Barbara S.; Mitchell, B. R.; Wyza, Margaret M.; Bennett, Karen J.; Gold, Alan J.

doi:10.1016/s0022-3476(05)83440-7

Cited by 58 publications

(27 citation statements)

References 7 publications

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“…60 However, a small clinical trial of human preterm infants showed no significant differences in clinical outcomes. 61 During administration, oxygen desaturation occurred more often when bolus administration was used, whereas reflux into the endotracheal tube occurred more often when the infusion technique was used. Similar clinical outcomes were also found when surfactant was administered as a bolus or as a 1-minute infusion through a side-hole adapter.…”

Section: Surfactant Administrationmentioning

confidence: 99%

“…There was no difference in clinical outcomes when 2 fractional doses of surfactant were given in 2 body positions compared with 4 fractional doses given in 4 positions. 61 Aerosolized surfactant preparations and continuous positive airway pressure-aided delivery of pharyngeal surfactant theoretically could allow administration without intubation; these preparations and route of delivery have yet to be proven effective. 59,62-64…”

Section: Surfactant Administrationmentioning

confidence: 99%

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Surfactant-Replacement Therapy for Respiratory Distress in the Preterm and Term Neonate

Engle¹

2008

Pediatrics

263

167

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Respiratory failure secondary to surfactant deficiency is a major cause of morbidity and mortality in preterm infants. Surfactant therapy substantially reduces mortality and respiratory morbidity for this population. Secondary surfactant deficiency also contributes to acute respiratory morbidity in late-preterm and term neonates with meconium aspiration syndrome, pneumonia/sepsis, and perhaps pulmonary hemorrhage; surfactant replacement may be beneficial for these infants. This statement summarizes indications, administration, formulations, and outcomes for surfactant-replacement therapy. The impact of antenatal steroids and continuous positive airway pressure on outcomes and surfactant use in preterm infants is reviewed. Because respiratory insufficiency may be a component of multiorgan dysfunction, preterm and term infants receiving surfactant-replacement therapy should be managed in facilities with technical and clinical expertise to administer surfactant and provide multisystem support.

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Section: Surfactant Administrationmentioning

confidence: 99%

Section: Surfactant Administrationmentioning

confidence: 99%

Surfactant-Replacement Therapy for Respiratory Distress in the Preterm and Term Neonate

Engle¹

2008

Pediatrics

263

167

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“…When comparing the different surfactant preparations, there are only small differences in the rate of mortality or bronchopulmonary dysplasia [55,133]. The best regime for the treatment of RDS is still under investigation [27,62,70,110,256,291,292,358]. However, despite all efforts, a group of infants (up to 30%) remains which does not respond to surfactant treatment [79].…”

Section: Therapeutic Use Of Surfactantmentioning

confidence: 99%

The Pulmonary Surfactant System: Biochemical and Clinical Aspects

Creuwels

Golde

Haagsman

1997

Lung

282

188

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Abstract. This article starts with a brief account of the history of research on pulmonary surfactant. We will then discuss the morphological aspects and composition of the pulmonary surfactant system. We describe the hydrophilic surfactant proteins A and D and the hydrophobic surfactant proteins B and C, with focus on the crucial roles of these proteins in the dynamics, metabolism, and functions of pulmonary surfactant. Next we discuss the major disorders of the surfactant system. The final part of the review will be focused on the potentials and complications of surfactant therapy in the treatment of some of these disorders. It is our belief that increased knowledge of the surfactant system and its functions will lead to a more optimal composition of the exogenous surfactants and, perhaps, widen their applicability to treatment of surfactant disorders other than neonatal respiratory distress syndrome.Key words: Surfactant protein-Pulmonary surfactant-Respiratory distress syndrome. HistoryResearch on surfactant goes back to 1929 when von Neergaard published the first paper about the difference in pressure needed to inflate lungs with air or with liquid [333]. He found that the pressure necessary for filling the lungs with air was higher than when the lungs were filled with liquid. To explain this result he stated that the alveoli were stabilized by lowering the naturally high surface tension of the air/water interface. In 1946 Thannhauser and co-workers reported that lung tissue has a remarkably high content of the lipid dipalmityl lecithin (current name, dipalmitoylphosphatidylcholine)Offprint requests to: Henk P. Haagsman.

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“…The medication is instilled in one or more aliquots, with the patient in supine position or in different positions, according to recommendations provided by each laboratory. The increase in the number of aliquots may not make much difference, 60 but the recommendations follow protocols that were used for testing each product. However, some commercial surfactants are too diluted, and the administration in one single aliquot may temporarily impair ventilation.…”

Section: Administration Techniquementioning

confidence: 99%

Terapia com surfactante pulmonar exógeno em pediatria

Freddi

Filho²,

Fiori³

2003

J. Pediatr. (Rio J.)

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Objective: To review current knowledge about the use of exogenous surfactants in the treatment of different lung diseases causing acute respiratory failure in children. Sources of data:This review is based on the authors' experience and on recent data retrieved from ONIA, Mdconsult, Medline and the Cochrane Database Library. Summary of the findings:In spite of the success of the use of exogenous surfactants in Respiratory Distress Syndrome (RDS) of the newborn, some questions remain unanswered, such as the optimal administration timing -either very early (prophylactic), based on gestational age or on quick tests of lung maturity, or later, when the clinical picture becomes unequivocal. In other severe diseases requiring ventilatory support, the use of surfactants is still controversial, and data in the literature are limited and conflicting. However, successful use in several other diseases has been reported. Recent studies have focused on surfactant inactivation by substances that can be found in the airways. New surfactants with the addition of substances to control inhibition, such as polyethyleneglycol, are being tested for diseases in which inactivation seems to be a significant factor. Conclusions:Therapy with exogenous surfactants, even as a treatment for RDS, has not been thoroughly investigated. Further studies should be conducted to improve surfactants -mainly their resistance to inhibition -and the treatment of diseases other than RDS.J Pediatr (Rio J) 2003;79 (Suppl 2):S205-S12: Exogenous surfactant, respiratory failure, intensive care, respiratory distress syndrome.

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Comparison of three dosing procedures for administration of bovine surfactant to neonates with respiratory distress syndrome

Cited by 58 publications

References 7 publications

Surfactant-Replacement Therapy for Respiratory Distress in the Preterm and Term Neonate

Surfactant-Replacement Therapy for Respiratory Distress in the Preterm and Term Neonate

The Pulmonary Surfactant System: Biochemical and Clinical Aspects

Terapia com surfactante pulmonar exógeno em pediatria

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