Universität zu Köln

Niemarkt, Hendrik J., Kuypers, Elke, Jellema, Reint ORCID: 0000-0002-6918-0930, Ophelders, Daan ORCID: 0000-0001-7410-5102, Huetten, Matthias, Nikiforou, Maria, Kribs, Angela and Kramer, Boris W. (2014). Effects of less-invasive surfactant administration on oxygenation, pulmonary surfactant distribution, and lung compliance in spontaneously breathing preterm lambs. Pediatr. Res., 76 (2). S. 166 - 171. NEW YORK: NATURE PUBLISHING GROUP. ISSN 1530-0447

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Abstract

BACKGROUND: A new technique was proposed to administer surfactant to spontaneous breathing preterm infants by placing a thin catheter through the vocal cords. This technique was not studied with respect to oxygenation, gas exchange, surfactant distribution, and lung mechanics. We tested the technique of less-invasive surfactant administration (LISA) in a spontaneous breathing preterm lamb model. METHODS: Preterm lambs (n = 12) of 133-134 d gestational age were randomized to the following three groups: (i) continuous positive airway pressure (CPAP) only, (ii) CPAP + LISA, and (iii) intubation and mechanical ventilation with surfactant administration. Surfactant was labeled with samarium oxide. During the next 180 min, blood gas analyses were performed. Postmortem, lungs were removed and surfactant distribution was assessed, and pressure-volume curves were performed. RESULTS: Pao(2) in the LISA-treated. lambs was significantly higher than in the lambs that exclusively received CPAP. Moreover, Pao(2) values were similar between the LISA-treated and the intubated lambs. Overall, surfactant deposition was less in the LISA lambs, with significantly less surfactant distributed to the right upper lobe. Lung compliance was better in the intubated lambs compared with the LISA-treated lambs, although this did not reach significance. CONCLUSION: LISA improved oxygenation, similar to conventional surfactant application techniques, despite lower surfactant deposition and lung compliance.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Niemarkt, Hendrik J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuypers, Elke UNSPECIFIED UNSPECIFIED UNSPECIFIED Jellema, Reint UNSPECIFIED orcid.org/0000-0002-6918-0930 UNSPECIFIED Ophelders, Daan UNSPECIFIED orcid.org/0000-0001-7410-5102 UNSPECIFIED Huetten, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Nikiforou, Maria UNSPECIFIED UNSPECIFIED UNSPECIFIED Kribs, Angela UNSPECIFIED UNSPECIFIED UNSPECIFIED Kramer, Boris W. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-433054
DOI:	10.1038/pr.2014.66
Journal or Publication Title:	Pediatr. Res.
Volume:	76
Number:	2
Page Range:	S. 166 - 171
Date:	2014
Publisher:	NATURE PUBLISHING GROUP
Place of Publication:	NEW YORK
ISSN:	1530-0447
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language POSITIVE AIRWAY PRESSURE; EXOGENOUS SURFACTANT; MECHANICAL VENTILATION; INFANTS; RABBITS; INSTILLATION; THERAPY; FAILURE; CPAP Multiple languages Pediatrics Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/43305