Nord Anders, Cunha-Goncalves Doris, Linnér Rikard, Bianco Federico, Salomone Fabrizio, Ricci Francesca, Lombardini Marta, Micaglio Massimo, Trevisanuto Daniele, Perez-de-Sa Valeria
Department of Clinical Sciences, Lund University, SE-221 84 Lund, Sweden.
Corporate R&D, Chiesi Farmaceutici S.p.A., 43122 Parma, Italy.
Pharmaceutics. 2021 Nov 4;13(11):1858. doi: 10.3390/pharmaceutics13111858.
It is unknown if the lung deposition of surfactant administered via a catheter placed through a laryngeal mask airway (LMA) is equivalent to that obtained by bolus instillation through an endotracheal tube. We compare the lung deposition of surfactant delivered via two types of LMA with the standard technique of endotracheal instillation. 25 newborn piglets on continuous positive airway pressure support (CPAP) were randomized into three groups: 1-LMA-camera (integrated camera and catheter channel; catheter tip below vocal cords), 2-LMA-standard (no camera, no channel; catheter tip above the glottis), 3-InSurE (Intubation, Surfactant administration, Extubation; catheter tip below end of endotracheal tube). All animals received 100 mg·kg of poractant alfa mixed with Technetium-nanocolloid. Surfactant deposition was measured by gamma scintigraphy as a percentage of the administered dose. The median (range) total lung surfactant deposition was 68% (10-85), 41% (5-88), and 88% (67-92) in LMA-camera, LMA-standard, and InSurE, respectively, which was higher ( < 0.05) in the latter. The deposition in the stomach and nasopharynx was higher with the LMA-standard. The surfactant deposition via an LMA was lower than that obtained with InSurE. Although not statistically significant, introducing the catheter below the vocal cords under visual control with an integrated camera improved surfactant LMA delivery by 65%.
经喉罩气道（LMA）放置的导管给予表面活性剂后，其在肺内的沉积是否等同于经气管插管大剂量注入的沉积尚不清楚。我们将通过两种类型的LMA给予表面活性剂后的肺内沉积与气管内注入的标准技术进行比较。25只接受持续气道正压通气支持（CPAP）的新生仔猪被随机分为三组：1-LMA-摄像头组（集成摄像头和导管通道；导管尖端位于声带下方），2-LMA-标准组（无摄像头，无通道；导管尖端位于声门上），3-InSurE组（插管、表面活性剂给药、拔管；导管尖端位于气管导管末端下方）。所有动物均接受100mg·kg的猪肺磷脂与锝纳米胶体混合液。通过γ闪烁显像术测量表面活性剂沉积量，以给药剂量的百分比表示。LMA-摄像头组、LMA-标准组和InSurE组的肺表面活性剂总沉积中位数（范围）分别为68%（10-85）、41%（5-88）和88%（67-92），InSurE组更高（P<0.05）。LMA-标准组在胃和鼻咽部的沉积更高。通过LMA给予表面活性剂的沉积低于InSurE组。尽管无统计学意义，但在集成摄像头视觉控制下将导管置于声带下方可使通过LMA给予表面活性剂的递送提高65%。
