Pasteka Richard, Hufnagl Lisa, Vodenicharov Vasil, Blessing Alissa, Berger Angelika, Wagner Michael, Werther Tobias
Department Life Science Engineering, Competence Centre Medical Engineering & Integrated Healthcare, University of Applied Sciences Technikum Wien, Vienna, Austria.
Department of Paediatrics and Adolescent Medicine, Comprehensive Centre for Paediatrics, Division of Neonatology, Paediatric Intensive Care and Neuropaediatrics, Medical University of Vienna, Vienna, Austria.
Pediatr Pulmonol. 2025 Jul;60(7):e71205. doi: 10.1002/ppul.71205.
To compare effects of bolus and aerosolization surfactant delivery methods and ventilatory support on improving ex-vivo premature sheep lung function.
The xPULM lung simulator was used with 16 ex-vivo preterm sheep lungs, of which 6 were analyzed in the bolus group and 3 in the aerosol group after excluding 7 lungs that ruptured during the trial. Surfactant (0.5 mL poractant alfa) was administered via bolus injection or aerosolization. Tidal volume (VT) was measured before and after administration at positive end-expiratory pressure (PEEP) levels of 0, 5, 10, and 15 cmH₂O.
Surfactant administration significantly increased VT (presurfactant median VT = 0.21 mL; post-surfactant median VT = 1.03 mL, p < 0.001). There was a trend toward higher median VT with bolus delivery (1.48 mL) compared to aerosolized delivery (0.43 mL) with borderline significance (p = 0.047) between the two delivery methods. High PEEP levels before surfactant delivery caused lung overdistention. Histological analysis revealed minimal lung tissue injury across samples, despite experimental challenges.
In ex-vivo preterm sheep lungs, surfactant delivery is the primary driver of improved lung function, while PEEP has a smaller impact. The xPULM lung simulator enables research during spontaneous breathing while avoiding ethical issues associated with animal models.
比较推注式和雾化式表面活性剂给药方法以及通气支持对改善离体早产绵羊肺功能的效果。
使用xPULM肺模拟器对16个离体早产绵羊肺进行研究，试验过程中有7个肺破裂，排除后，推注组分析6个肺，雾化组分析3个肺。通过推注或雾化方式给予表面活性剂（0.5 mL猪肺磷脂）。在呼气末正压（PEEP）水平为0、5、10和15 cmH₂O时，测量给药前后的潮气量（VT）。
给予表面活性剂后VT显著增加（给药前VT中位数 = 0.21 mL；给药后VT中位数 = 1.03 mL，p < 0.001）。推注给药的VT中位数（1.48 mL）有高于雾化给药（0.43 mL）的趋势，两种给药方法之间的差异具有临界显著性（p = 0.047）。表面活性剂给药前的高PEEP水平导致肺过度膨胀。组织学分析显示，尽管存在实验挑战，但各样本的肺组织损伤最小。
在离体早产绵羊肺中，表面活性剂给药是改善肺功能的主要驱动因素，而PEEP的影响较小。xPULM肺模拟器能够在自主呼吸期间进行研究，同时避免与动物模型相关的伦理问题。
