Aerosol Delivery of Lung Surfactant and Nasal CPAP in the Treatment of Neonatal Respiratory Distress Syndrome

Frontiers in Pediatrics

Alan J. Waring¹  Frans J. Walther³ 

[1] Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States;Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States;Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, United States;

关键词: surfactant;    nasal CPAP;    non-invasive ventilation;    aerosol delivery;    nebulization;    neonatal respiratory distress syndrome;   

DOI  :  10.3389/fped.2022.923010

来源: DOAJ

【 摘 要 】

After shifting away from invasive mechanical ventilation and intratracheal instillation of surfactant toward non-invasive ventilation with nasal CPAP and less invasive surfactant administration in order to prevent bronchopulmonary dysplasia in preterm infants with respiratory distress syndrome, fully non-invasive surfactant nebulization is the next Holy Grail in neonatology. Here we review the characteristics of animal-derived (clinical) and new advanced synthetic lung surfactants and improvements in nebulization technology required to secure optimal lung deposition and effectivity of non-invasive lung surfactant administration. Studies in surfactant-deficient animals and preterm infants have demonstrated the safety and potential of non-invasive surfactant administration, but also provide new directions for the development of synthetic lung surfactant destined for aerosol delivery, implementation of breath-actuated nebulization and optimization of nasal CPAP, nebulizer circuit and nasal interface. Surfactant nebulization may offer a truly non-invasive option for surfactant delivery to preterm infants in the near future.

【 授权许可】

Unknown