Nebulizing poractant alfa versus conventional instillation: Ultrastructural appearance and preservation of surface activity.

Minocchieri, Stefan; Knoch, Stephan Florian; Schoel, W. Michael; Ochs, Matthias; Nelle, Mathias (2014). Nebulizing poractant alfa versus conventional instillation: Ultrastructural appearance and preservation of surface activity. Pediatric pulmonology, 49(4), pp. 348-356. Wiley-Blackwell 10.1002/ppul.22838

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BACKGROUND Nebulized surfactant therapy has been proposed as an alternative method of surfactant administration. The use of a perforated vibrating membrane nebulizer provides a variety of advantages over conventional nebulizers. We investigated the molecular structure and integrity of poractant alfa pre- and post-nebulization. METHOD Curosurf® was nebulized using an Investigational eFlow® Nebulizer System. Non-nebulized surfactant ("NN"), recollected surfactant droplets from nebulization through an endotracheal tube ("NT") and nebulization of surfactant directly onto a surface ("ND") were investigated by transmission electron microscopy. Biophysical characteristics were assessed by the Langmuir-Wilhelmy balance and the Captive Bubble Surfactometer. RESULTS Volume densities of lamellar body-like forms (LBL) and multi-lamellar forms (ML) were high for "NN" and "NT" samples (38.8% vs. 47.7% for LBL and 58.2% vs. 47.8% for ML). In the "ND" sample, we found virtually no LBL's, ML's (72.6%) as well as uni-lamellar forms (16.4%) and a new structure, the "garland-like" forms (9.4%). Surface tension for "NN" and "NT" was 23.33 ± 0.29 and 25.77 ± 1.12 mN/m, respectively. Dynamic compression-expansion cycling minimum surface tensions were between 0.91 and 1.77 mN/m. CONCLUSION The similarity of surfactant characteristics of nebulized surfactant via a tube and the non-nebulized surfactant suggests that vibrating membrane nebulizers are suitable for surfactant nebulization. Alterations in surfactant morphology and characteristics after nebulization were transient. A new structural subtype of surfactant was identified. Pediatr Pulmonol. 2014; 49:348-356. © 2013 Wiley Periodicals, Inc.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine > Neonatology
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Anatomy

UniBE Contributor:

Minocchieri, Stefan; Ochs, Matthias and Nelle, Mathias

Subjects:

500 Science
600 Technology > 610 Medicine & health

ISSN:

8755-6863

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

André Schaller

Date Deposited:

11 Jun 2014 10:08

Last Modified:

29 Oct 2015 10:18

Publisher DOI:

10.1002/ppul.22838

PubMed ID:

24039226

Uncontrolled Keywords:

aerosol drug therapy, nebulizer neonatal respiratory distress syndrome, pulmonary surfactant, surface tension

BORIS DOI:

10.7892/boris.50248

URI:

https://boris.unibe.ch/id/eprint/50248

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