Document Detail

Surfactant nebulisation: safety, efficiency and influence on surface lowering properties and biochemical composition.
MedLine Citation:
PMID:  9142589     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The objectives of this study were, to select a nebuliser first, that operates safely in a neonatal ventilator setting and, second, that is most efficient. Thirdly, we studied the particle sizes of the surfactant aerosol. Fourthly, we studied where the nebulised surfactant is deposited in the tubing system of the ventilator. Finally, we studied whether nebulisation influences the composition and biophysical properties of surfactant. MEASUREMENTS AND RESULTS: Safety was assessed by measuring "mean airway pressures" in a test lung before, during and after surfactant nebulisation, for three jet nebulisers. The MiniNEB did not alter these pressures, and is thus safe, whereas the other two nebulisers (Intersurgical and Flo-Thru) increased these pressures. The efficiency of nebulisation was assessed by measuring the amount of phospholipid deposited in the test lung. The MiniNEB showed the highest efficiency: 10% versus 1-3% of the other two nebulisers. The particle sizes of surfactant aerosol were assessed by the laser diffraction method. Seventy percent of the particles were 1-5 microns. The deposition of surfactant aerosol in the tubing system was assessed by nebulising surfactant that was labelled with 99mTc Nanocoll. Afterwards the tubing system was imaged using a gamma camera. The majority of surfactant was deposited in the expiratory hose (28%), nebuliser (20%), Y-piece (16%) and expiratory filter (12%). Finally the phospholipid composition, spreading velocity, static and dynamic surface tensions were assessed for the nebulised surfactant and compared to the stock surfactant. In addition, nebulised surfactant was instilled in premature rabbits and tidal volumes were measured to assess the dose-response relation. We found that neither the composition nor biophysical properties had been altered by nebulisation. CONCLUSIONS: The MiniNEB nebulised surfactant safely in a neonatal ventilator setting with respect to airway pressures. The efficiency of nebulisation is low: the majority of the surfactant aerosol is deposited in the expiratory tubing. The surfactant composition and function is not altered by nebulisation. Therefore the nebulisation of surfactant is feasible, but efforts should be made to improve the efficiency of this procedure.
P H Dijk; A Heikamp; D A Piers; E Weller; S Bambang Oetomo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Intensive care medicine     Volume:  23     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  1997 Apr 
Date Detail:
Created Date:  1997-08-05     Completed Date:  1997-08-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  456-62     Citation Subset:  IM    
Department of Pediatrics, Beatrix Children's Hospital, University Hospital, Groningen, The Netherlands.
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MeSH Terms
Confidence Intervals
Dose-Response Relationship, Drug
Equipment Safety
Evaluation Studies as Topic
Infant, Newborn
Linear Models
Lung / chemistry
Nebulizers and Vaporizers / standards*
Particle Size
Pulmonary Surfactants / administration & dosage*,  chemistry
Respiration, Artificial / methods
Reg. No./Substance:
0/Aerosols; 0/Pulmonary Surfactants

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