新生儿呼吸窘迫动物模型中表面活性剂的雾化吸入
Nebulisation of surfactants in an animal model of neonatal respiratory distress.
作者信息
Fok T F, al-Essa M, Dolovich M, Rasid F, Kirpalani H
机构信息
Department of Paediatrics, McMaster University Medical Centre, Hamilton, Ontario, Canada.
出版信息
Arch Dis Child Fetal Neonatal Ed. 1998 Jan;78(1):F3-9. doi: 10.1136/fn.78.1.f3.
AIMS
To evaluate pulmonary deposition and gas exchange following nebulisation of two surfactants by either a jet or an ultrasonic nebuliser.
METHOD
After bronchoalveolar lavage (BAL), 19 rabbits were ventilated in four groups. Group A1 (n = 5) and A2 (n = 6) received Technetium-99m labelled Exosurf, and groups B1 (n = 4) and B2 (n = 4) received radiolabelled Survanta. Groups A1 and B1 received jet nebuliser therapy, whereas groups A2 and B2 received ultrasonic nebuliser. Pulmonary deposition, distribution, and blood gases were determined.
RESULTS
Pulmonary deposition as per cent of initial dose and mg lipid) was 0.28(0.10)% or 0.59(0.21) mg in group A1, 1.05(0.23)% or 2.21(0.48) mg in group A2, 0.08(0.02)% or 0.30(0.08) mg in group B1, and 0.09(0.02)% or 0.34(0.08) mg in group B2. Deposition in group A2 was greater than in other groups (p = 0.001). Group A2 showed a small improvement in blood gases.
CONCLUSIONS
Even the highest deposition--ultrasonic nebuliser with Exosurf--achieved limited clinical effect. The aerosol route is currently not effective for surfactant treatment.
目的
评估通过喷射雾化器或超声雾化器雾化两种表面活性剂后的肺部沉积和气体交换情况。
方法
对19只兔子进行支气管肺泡灌洗（BAL）后，分为四组进行通气。A1组（n = 5）和A2组（n = 6）接受99m锝标记的Exosurf，B1组（n = 4）和B2组（n = 4）接受放射性标记的Survanta。A1组和B1组接受喷射雾化器治疗，而A2组和B2组接受超声雾化器治疗。测定肺部沉积、分布和血气情况。
结果
以初始剂量的百分比和毫克脂质计算，A1组的肺部沉积为0.28（0.10）%或0.59（0.21）毫克，A2组为1.05（0.23）%或2.21（0.48）毫克，B1组为0.08（0.02）%或0.30（0.08）毫克，B2组为0.09（0.02）%或0.34（0.08）毫克。A2组的沉积大于其他组（p = 0.001）。A2组的血气有小幅改善。
结论
即使是最高沉积量——Exosurf与超声雾化器联用——临床效果也有限。目前，气雾剂途径用于表面活性剂治疗并不有效。
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