Surface active drugs significantly alter the drug output rate from medical nebulizers

Arzhavitina, A.; Steckel, Hartwig

doi:10.1016/j.ijpharm.2009.10.012

Cited by 39 publications

(22 citation statements)

References 18 publications

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“…77 Aerosolized surfactant would be the least invasive and probably most desirable way of administering surfactant. Progress has recently been made toward solving the technical problems of surfactant nebulization by using vibrating membrane nebulizers, [78][79][80] but more clinical data are needed on the efficacy of aerosolized surfactant and of other innovative methods of administering surfactant. Moreover, future RCTs should investigate the optimal timing of surfactant administration.…”

Section: Implications For Researchmentioning

confidence: 99%

Avoiding Endotracheal Ventilation to Prevent Bronchopulmonary Dysplasia: A Meta-analysis

2013

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Avoiding Endotracheal Ventilation to Prevent Bronchopulmonary Dysplasia: A Meta-analysis abstract BACKGROUND AND OBJECTIVE: Mechanical ventilation via an endotra-cheal tube is a risk factor for bronchopulmonary dysplasia (BPD), one of the most common morbidities of very preterm infants. Our objective was to investigate the effect that strategies to avoid endotracheal mechanical ventilation (eMV) have on the incidence of BPD in preterm infants ,30 weeks' gestational age (GA). METHODS: In February 2013, we searched the databases Medline, Embase, and the Cochrane Central Register of Controlled Trials. Study selection criteria included randomized controlled trials published in peer-reviewed journals since the year 2000 that compared preterm infants ,30 weeks' GA treated by using a strategy aimed at avoiding eMV with a control group in which mechanical ventilation via an endotracheal tube was performed at an earlier stage. Data were extracted and analyzed by using the standard methods of the Cochrane Neonatal Review Group. The authors independently assessed study eligibility and risk of bias, extracted data and calculated odds ratios and 95% confidence intervals, employing RevMan version 5.1.6. RESULTS: We identified 7 trials that included a total of 3289 infants. The combined odds ratio (95% confidence interval) of death or BPD was 0.83 (0.71-0.96). The number needed to treat was 35. The study results were remarkably homogeneous. Avoiding eMV had no influence on the incidence of severe intraventricular hemorrhage.

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Section: Implications For Researchmentioning

confidence: 99%

Avoiding Endotracheal Ventilation to Prevent Bronchopulmonary Dysplasia: A Meta-analysis

2013

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“…The process was safe with a low existence of ‘peridosing events’ but lack of efficiency because of the absence of a control group. Arzhavitina et al compared six different nebulizers in an in vitro model [103]. They reported that the VM nebulizer is the superlative device for substances with surface activity, such as surfactants, because the residual volume in the device is negligible and the substance output is maximal.…”

Section: Delivery Methods Of Pulmonary Surfactant Therapymentioning

confidence: 99%

“…In addition, patients with obstructive lung diseases, such as cystic fibrosis, commonly have a greater concentration of delivered medication in the central airway passages than in peripheral regions, based on the unusual aerodynamics associated with partially obstructed flows. Recently, low surface tension carrier fluids have emerged to improve pulmonary drug distribution, provide more reliable peripheral lung dosing, and increase survival in a model of pulmonary infection [103,111]. The success of surfactant replacement therapy has initiated an investigation into using exogenous surfactant to improve the uniformity of aerosolized drug delivery in the lungs.…”

Section: Exogenous Surfactant As a Drug Delivery-carriermentioning

confidence: 99%

Delivery and Performance of Surfactant Replacement Therapies to Treat Pulmonary Disorders

et al. 2013

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Lung surfactant is crucial for optimal pulmonary function throughout life. An absence or deficiency of surfactant can affect the surfactant pool leading to respiratory distress. Even if the coupling between surfactant dysfunction and the underlying disease is not always well understood, using exogenous surfactants as replacement is usually a standard therapeutic option in respiratory distress. Exogenous surfactants have been extensively studied in animal models and clinical trials. The present article provides an update on the evolution of surfactant therapy, types of surfactant treatment, and development of newer-generation surfactants. The differences in the performance between various surfactants are highlighted and advanced research that has been conducted so far in developing the optimal delivery of surfactant is discussed.

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“…However, physiological differences between the acute lung injury model and our preterm RDS model have to be taken into account when comparing different surfactant preparations. In addition, different nebulization techniques showed differences in their suitability for surfactant nebulization (32), and different surface active substances affected nebulization depending on the nebulizer (33). The nebulizer we used has been reported to be suitable for nebulization of Poractant alfa, and surfactant characteristics were similar before and after nebulization (34).…”

Section: Surfactant Distribution Relative To Wholementioning

confidence: 96%

Nebulization of Poractant alfa via a vibrating membrane nebulizer in spontaneously breathing preterm lambs with binasal continuous positive pressure ventilation

et al. 2015

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Surface active drugs significantly alter the drug output rate from medical nebulizers

Cited by 39 publications

References 18 publications

Avoiding Endotracheal Ventilation to Prevent Bronchopulmonary Dysplasia: A Meta-analysis

Avoiding Endotracheal Ventilation to Prevent Bronchopulmonary Dysplasia: A Meta-analysis

Delivery and Performance of Surfactant Replacement Therapies to Treat Pulmonary Disorders

Nebulization of Poractant alfa via a vibrating membrane nebulizer in spontaneously breathing preterm lambs with binasal continuous positive pressure ventilation

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