Positive end‐expiratory pressure and surfactant administration mode influence function in ex‐vivo premature sheep lungs

Aim Respiratory distress syndrome often necessitates endotracheal surfactant administration in extremely preterm infants. Our study aimed to explore a multi‐modal simulation tool for investigating treatment strategies in ex vivo sheep lungs during spontaneous breathing. Methods An electromechanical...

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Bibliographic Details
Published in:Acta Paediatrica 2024-04, Vol.113 (4), p.722-730
Main Authors: Pasteka, Richard, Hufnagl, Lisa, Forjan, Mathias, Berger, Angelika, Werther, Tobias, Wagner, Michael
Format: Article
Language:English
Subjects:
Investigations
lung
Lungs
preterm infant
Respiration
Respiratory distress syndrome
Respiratory system
Sheep
surfactant
Surfactants
tidal volume
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Summary:Aim Respiratory distress syndrome often necessitates endotracheal surfactant administration in extremely preterm infants. Our study aimed to explore a multi‐modal simulation tool for investigating treatment strategies in ex vivo sheep lungs during spontaneous breathing. Methods An electromechanical lung simulator (xPULM) mimicking spontaneous breathing was coupled with a non‐aerated premature sheep lung, replicating a premature respiratory system. Changes in tidal volume for different positive end‐expiratory pressure (PEEP) levels prior to and after either bolus or nebulised surfactant administration were compared. Results In two preterm sheep lungs, we observed a progressive decline in tidal volume with increasing PEEP levels prior to surfactant delivery from 0.30 ± 0.01 mL at zero PEEP to 0.04 ± 0.01 mL at 15 cmH2O PEEP. Our measurements showed that both bolus (p 
ISSN:0803-5253
1651-2227
1651-2227
DOI:10.1111/apa.17083