Structural and haemodynamic evaluation of less invasive surfactant administration during nasal intermittent positive pressure ventilation in surfactant-deficient newborn piglets

The most recent approaches to the initial treatment of respiratory distress syndrome (RDS)- involve non-invasive ventilation (NIV) and less-invasive surfactant (SF) administration (LISA). Combining these techniques has been proven a useful treatment option for SF-deficient neonates. The objective of...

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Bibliographic Details
Published in:PloS one 2023-04, Vol.18 (4), p.e0284750-e0284750
Main Authors: Mielgo, Victoria, Gastiasoro, Elena, Salomone, Fabrizio, Ricci, Francesca, Gomez-Solaetxe, Miguel A, Olazar, Lara, Loureiro, Begoña, Rey-Santano, Carmen
Format: Article
Language:English
Subjects:
Analysis
Animals
Animals, Newborn
Biology and Life Sciences
Brain
Brain injury
Brain research
Bronchus
Catheters
Continuous Positive Airway Pressure - methods
Engineering and Technology
Evaluation
Extubation
Head injuries
Health aspects
Hemodynamics
Humans
Infant, Newborn
Infrared spectroscopy
Injuries
Injury analysis
Intermittent Positive-Pressure Ventilation - methods
Larynx
Lavage
Lipoproteins
Lungs
Mechanical ventilation
Medical instruments
Medical research
Medicine and Health Sciences
Near infrared radiation
Near infrared spectroscopy
Neonates
Newborn babies
Physiological aspects
Properties
Pulmonary Surfactants
Research and Analysis Methods
Respiratory agents
Respiratory distress syndrome
Respiratory Distress Syndrome - therapy
Respiratory Distress Syndrome, Newborn - drug therapy
Surface active agents
Surfactants
Swine
Ventilation
Ventilators
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Summary:The most recent approaches to the initial treatment of respiratory distress syndrome (RDS)- involve non-invasive ventilation (NIV) and less-invasive surfactant (SF) administration (LISA). Combining these techniques has been proven a useful treatment option for SF-deficient neonates. The objective of this study was to explore the impact on the brain (using cerebral near infrared spectroscopy, NIRS) of different LISA methods during NIV, using nasal intermittent positive pressure ventilation (NIPPV) for treating neonatal RDS. For this, we used five groups of spontaneously breathing newborn piglets (n = 6/group) with bronchoalveolar lavage (BAL)-induced respiratory distress which received NIPPV only (controls), poractant-alfa using the INSURE-like method (bolus delivery) followed by NIPPV, or poractant-alfa using one of three LISA devices, 1) a nasogastric tube (NT), 2) a vascular catheter (VC) or 3) the LISAcath® catheter. We assessed pulmonary, hemodynamic and cerebral effects, and performed histological analysis of lung and brain tissue. Following BALs, the piglets developed severe RDS (pH70 mmHg, PaO2
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0284750