In Vitro Evaluation of a Device for Intra-Pulmonary Aerosol Generation and Delivery.
In Vitro Evaluation of a Device for Intra-Pulmonary Aerosol Generation and Delivery.
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DOI：
10.1080/02786826.2015.1067670
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发表时间：
2015-09-01
期刊：
影响因子：
--
通讯作者：
Somani A
中科院分区：
文献类型：
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作者：
Syedain ZH;Naqwi AA;Dolovich M;Somani A
对于出生时患有呼吸窘迫综合征（RDS）的婴儿，通过气管内导管给予表面活性剂的液体推注是常见的做法。虽然这种方法通常是有效的，但可能会发生并发症，如短暂缺氧，高碳酸血症和脑血流改变。雾化吸入表面活性剂治疗已被探索作为一种替代方案。不幸的是，过去的努力导致了令人失望的结果，因为气溶胶是在肺外产生的，具有显著的咽部沉积和最小的肺内滴注。本文评价了新型气雾剂发生器（Microjet™）在气管内导管内的肺内气雾剂产生，并用Curosurf和Infasurf表面活性剂进行测试。与其他气溶胶输送装置相比，该过程利用低空气流量（范围0.01-0.2 L/min），这对于限制早产新生儿肺的潜在气压伤是理想的。两种测试的表面活性剂的颗粒的质量平均直径（MMD）小于4 μm，这对于均匀和远端肺递送都是理想的。作为磷脂功能的指标，在气溶胶形成之前和之后测量表面活性剂表面张力;没有显著差异。此外，该装置具有<1 mm的外径，这允许插入气管内导管（甚至2.0mm）中。在早产儿中，静脉通路在技术上具有挑战性或困难，气雾剂给药可为患者复苏、稳定和护理提供替代途径。这种类型的装置的其他潜在应用包括经由肺部途径递送营养物、抗生素和镇痛剂。
For infants born with respiratory distress syndrome (RDS), liquid bolus delivery of surfactant administered through an endotracheal tube is common practice. While this method is generally effective, complications such as transient hypoxia, hypercapnia, and altered cerebral blood flow may occur. Aerosolized surfactant therapy has been explored as an alternative. Unfortunately, past efforts have led to disappointing results as aerosols were generated outside the lungs with significant pharyngeal deposition and minimal intrapulmonary instillation. A novel aerosol generator (Microjet™) is evaluated herein for intrapulmonary aerosol generation within an endotracheal tube and tested with Curosurf and Infasurf surfactants. Compared with other aerosol delivery devices, this process utilizes low air flow (range 0.01-0.2 L/min) that is ideal for limiting potential barotrauma to the premature newborn lung. The mass mean diameter (MMD) of the particles for both tested surfactants was less than 4 μm, which is ideal for both uniform and distal lung delivery. As an indicator of phospholipid function, surfactant surface tension was measured before and after aerosol formation; with no significant difference. Moreover, this device has an outside diameter of <1mm, which permits insertion into an endotracheal tube (of even 2.0 mm). In the premature infant where intravenous access is either technically challenging or difficult, aerosol drug delivery may provide an alternative route in patient resuscitation, stabilization and care. Other potential applications of this type of device include the delivery of nutrients, antibiotics, and analgesics via the pulmonary route.