Exogenous surfactant replacement immediately at birth as preventive therapy for lung prematurity in neonatal lambs Surfactant prophylactic therapy for premature neonatal lambs

2021 ◽  
Author(s):  
Liege C.G. Silva ◽  
Daniel S.R. Angrimani ◽  
Fernanda M. Regazzi ◽  
Cristina F. Lúcio ◽  
Gisele A.L. Veiga ◽  
...  
Keyword(s):  
Preventive Therapy ◽  
Exogenous Surfactant ◽  
Prophylactic Therapy ◽  
Surfactant Replacement ◽  
Neonatal Lambs

scholarly journals Surfactant Replacement Therapy for Respiratory Distress Syndrome in the Newborn: A Review

2017 ◽  
Vol 40 (1) ◽  
pp. 26-30
Author(s):  
Tahsinul Amin ◽  
Mohammod Shahidullah
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Pulmonary Hemorrhage ◽  
Surfactant Therapy ◽  
Respiratory Morbidity ◽  
Exogenous Surfactant ◽  
Surfactant Replacement ◽  
Surfactant Deficiency ◽  
Surfactant Replacement Therapy

Respiratory failure secondary to surfactant deficiency is a major cause of morbidity and mortality in low birth weight premature infants. Surfactant therapy substantially reduces mortality and respiratory morbidity for this population. Exogenous surfactant therapy has become well established in newborn infants with respiratory distress. Many aspects of its use have been well evaluated in high-quality trials and systematic reviews. Secondary surfactant deficiency also contributes to acute respiratory morbidity in late-preterm and term neonates with meconium aspiration syndrome, pneumonia/ sepsis, and perhaps pulmonary hemorrhage; surfactant replacement may be beneficial for these infants. This article summarizes the evidence and gives recommendations for the use of surfactant therapy for respiratory distress syndrome (RDS) in newborn.Bangladesh J Child Health 2016; VOL 40 (1) :26-30

Surfactant replacement increases compliance in premature lamb lungs during partial liquid ventilation in situ

1998 ◽  
Vol 84 (4) ◽  
pp. 1316-1322 ◽  
Author(s):  
Peter Tarczy-Hornoch ◽  
Jack Hildebrandt ◽  
Thomas A. Standaert ◽  
J. Craig Jackson
Keyword(s):  
Force Balance ◽  
Exogenous Surfactant ◽  
Partial Liquid Ventilation ◽  
Liquid Ventilation ◽  
Lung Inflation ◽  
Surfactant Replacement ◽  
Improve Compliance ◽  
Alveolar Surface ◽  
Force Balance Equation

Treatments available to improve compliance in surfactant-deficient states include exogenous surfactant (ES) and either partial (PLV) or total liquid ventilation (TLV) with perfluorochemical (PFC). Because of the additional air-lung and air-PFC interfaces introduced during PLV compared with TLV, we hypothesized that compliance would be worse during PLV than during TLV. Because surfactant is able to reduce interfacial tension between air and lung as well as between PFC and lung, we further hypothesized that compliance would improve with surfactant treatment before PLV. In excised preterm lamb lungs, we used Survanta for surfactant replacement and perflubron as the PFC. Compliance during PLV was intermediate between TLV and gas inflation, both with and without surfactant. Surfactant improved compliance during PLV, compared with PLV alone. Because of the force-balance equation governing the behavior of immiscible droplets on liquid surfaces, we predict that PFC droplets spread during PLV to cover the alveolar surface in surfactant-deficient lungs during most of lung inflation and deflation but that the PFC would retract into droplets in surfactant-sufficient lungs, except at end inspiration.

Effects of hemoglobin and cell membrane lipids on pulmonary surfactant activity

1987 ◽  
Vol 63 (4) ◽  
pp. 1434-1442 ◽  
Author(s):  
B. A. Holm ◽  
R. H. Notter
Keyword(s):  
Surface Tension ◽  
Erythrocyte Membrane ◽  
Membrane Lipids ◽  
Dynamic Compression ◽  
Lung Surfactant ◽  
Lung Mechanics ◽  
Exogenous Surfactant ◽  
Dynamic Surface ◽  
Surfactant Replacement ◽  
Surfactant Replacement Therapy

These experiments characterize the effects of hemoglobin and erythrocyte membrane lipids on the dynamic surface activity and adsorption facility of whole lung surfactant (LS) and a calf lung surfactant extract (CLSE) used clinically in surfactant replacement therapy for the neonatal respiratory distress syndrome (RDS). The results show that, at concentrations from 25 to 200 mg/ml, hemoglobin (Hb) increased the minimum dynamic surface tension of LS or CLSE mixtures (0.5 and 1.0 mumol/ml) from less than 1 to 25 dyn/cm on an oscillating bubble apparatus at 37 degrees C. Similarly, erythrocyte membrane lipids (0.5–3 mumol/ml) also prevented LS and CLSE suspensions (0.5–2.0 mumol/ml) from lowering surface tension below 19 dyn/cm under dynamic compression on the bubble. Surface pressure-time adsorption isotherms for LS suspensions (0.084 and 0.168 mumol phospholipid/ml) were also adversely affected by Hb (0.3–2.5 mg/ml), having a slower adsorption rate and magnitude. Significantly, these inhibitory effects of Hb and membrane lipids could be abolished if LS and CLSE concentrations were raised to high levels. In complementary physiological experiments, instillation of Hb, membrane lipids, or albumin into excised rat lungs was shown to cause a decrease in pressure-volume compliance. This decreased compliance was most prominent in lungs made partially surfactant deficient before inhibitor delivery and could be reversed by supplementation with active exogenous surfactant. Taken together, these data show that molecular components in hemorrhagic pulmonary edema can biophysically inactivate endogenous LS and adversely affect lung mechanics. Moreover, exogenous surfactant replacement can reverse this process even in the continued presence of inhibitor molecules and thus has potential utility in therapy for adult as well as neonatal RDS.

Computational Modeling of Surfactant-Laden Liquid Plug Propagation in Capillary Tubes

2012 ◽  
Author(s):  
Metin Muradoglu ◽  
Ufuk Olgac
Keyword(s):  
Replacement Therapy ◽  
Pulmonary Surfactant ◽  
Distress Syndrome ◽  
Standard Treatment ◽  
Exogenous Surfactant ◽  
Liquid Plug ◽  
Front Tracking Method ◽  
Surfactant Replacement ◽  
Surfactant Replacement Therapy ◽  
Shed Light

Pulmonary surfactant is of essential importance in reducing the surface tension on the liquid film that coats the inner surface of the airways and thus making the lung more compliant. Surfactant-deficiency may result in respiratory distress syndrome (RDS), which is especially common in prematurely born neonates. Surfactant replacement therapy (SRT) is a standard treatment, in which a liquid plug with exogenous surfactant is instilled in the trachea, which subsequently propagates by inspiration and spreads the exogenous surfactant to the airways. The efficacy of the treatment depends on various parameters such as the size of the liquid plug, inspiration frequency and the physical properties of the exogenous surfactant. Unsteady simulations are performed to study surfactant-laden liquid plug propagation using finite difference/front-tracking method in order to shed light on the surfactant replacement therapy.

Lung Surfactant in an Era of Replacement Therapy

PEDIATRICS ◽  
1981 ◽  
Vol 68 (6) ◽  
pp. 781-789
Author(s):  
Robert H. Notter ◽  
Donald L. Shapiro
Keyword(s):  
Replacement Therapy ◽  
Current Knowledge ◽  
Lung Surfactant ◽  
Potential Effect ◽  
Human Infant ◽  
Strong Interactions ◽  
Exogenous Surfactant ◽  
Surfactant Replacement ◽  
Surfactant Replacement Therapy

In this paper current knowledge of the palmonary surfactant system with particular emphasis on aspects that relate to exogenous surfactant replacement therapy for the neonatal respiratory distress syndrome (RDS) is considered. The work provides an overview, but concentrates on several facets of lung surfactant research that help to elucidate and evaluate past and present attempts toward such therapy. Subjects addressed include the functional need for specific lung surfactant components to obtain optimal surface activity and some of the required surface property measurements to characterize such activity. Also discussed is current knowledge of lung surfactant synthesis and secretion and the potential effect of exogenous surfactant on the endogenous pulmonary surfactant sytem. A primary theme throughout is that an analysis of previous clinical trials involving surfactant replacement shows the necessity for strong interactions with related basic science investigations. It is suggested that future human infant surfactant replacement trials proceed deliberately, and include maximal correlations with basic in vitro research on lung surfactant biophysics and biochemistry and with experiments in animal models.

DHE retard for prophylactic therapy of migraine: efficacy and tolerability

Cephalalgia ◽  
1983 ◽  
Vol 3 (1_suppl) ◽  
pp. 179-184
Author(s):  
Vincenzo Centonze ◽  
Ettore Attolini ◽  
Luigi Santoiemma ◽  
Caterina Brucoli ◽  
Giuseppe Macinagrossa ◽  
...  
Keyword(s):  
Cardiovascular System ◽  
Cardiovascular Function ◽  
Preventive Therapy ◽  
Prophylactic Therapy ◽  
Morphological Parameters ◽  
Good Efficacy ◽  
Sono Stati ◽  
Base De Données

The authors evaluated the efficacy of a DHE methanesulphonate for migraine attacks and its tolerability on liver, gallbladder and cardiovascular system functions. Twenty-eight patients affected by migraine were studied. They were withdrawn from preventive therapy for at least one month and treated for three months. The drug showed a good efficacy with a statistical significant reduction of severity and duration of attacks. No variation of the biochemical and morphological parameters of liver, gallbladder and cardiovascular function were found throughout the treatment. Les Auteurs ont évalué l'efficacité contre les crises migraineuses et la tolérance, sur la base de données hépato-biliaires et cardio-vasculaires, de la DHE à liberation programmée. 28 patients migraineux ont été traités pendant 3 mois par la DHE à liberation programmée, à la dose de 10 mg par jour. Les résultats ont montré une excellente tolérance et une très bonne efficacité de la DHE à liberation programmée, en particulière contre l'intensité et la durée des crises migraineuses. Gli AA. hanno valutato l'efficacia nel controllo delle crisi emicraniche e la tollerabilità nei confronti dell'apparato epato-biliare e cardio-vascolare, di una DHE metansulfonato a cessione programmata, in grado cioé di garantire la liberazione graduale nell'arco delle 24 ore del principio attivo. Sono stati studiati 28 soggetti affetti da emicrania, esenti da almeno un mese da terapie preventive e trattati per 3 mesi con DHE retard. Il farmaco ha dimostrato una buona efficacia con significativa riduzione della intensità e della durata delle crisi. Nessuna alterazione è stata riscontrata, inoltre, a carico dei parametri valutati.

Effect of exogenous surfactant instillation on experimental acute lung injury

1989 ◽  
Vol 66 (4) ◽  
pp. 1846-1851 ◽  
Author(s):  
J. D. Harris ◽  
F. Jackson ◽  
M. A. Moxley ◽  
W. J. Longmore
Keyword(s):  
Acute Lung Injury ◽  
Lung Injury ◽  
Surface Activity ◽  
Pulmonary Surfactant ◽  
Exogenous Surfactant ◽  
Protein Ratio ◽  
Surfactant Replacement ◽  
Lung Injury Model ◽  
Surfactant Phospholipids ◽  
The Individual

Pulmonary surfactant replacement has previously been shown to be effective in the human neonatal respiratory distress syndrome. The value of surfactant replacement in models of acute lung injury other than quantitative surfactant deficiency states is, however, uncertain. In this study an acute lung injury model using rats with chronic indwelling arterial catheters, injured with N-nitroso-N-methylurethane (NNNMU), has been developed. The NNNMU injury was found to produce hypoxia, increased mortality, an alveolitis, and alterations in the pulmonary surfactant system. Alterations of surfactant obtained by bronchoalveolar lavage included a reduction in the phospholipid-to-protein ratio, reduced surface activity, and alterations in the relative percentages of the individual phospholipids compared with controls. Treatment of the NNNMU-injured rats with instilled exogenous surfactant (Survanta) improved oxygenation; reduced mortality to control values; and returned the surfactant phospholipid-to-protein ratio, surface activity, and, with the exception of phosphatidylglycerol, the relative percentages of individual surfactant phospholipids to control values.

Treatment and management of migraine

2020 ◽  
pp. 152-164
Author(s):  
Andrew Charles ◽  
Stefan Evers
Keyword(s):  
Clinical Trials ◽  
Preventive Therapy ◽  
Mechanisms Of Action ◽  
Prophylactic Therapy ◽  
Antihypertensive Medications ◽  
Headache Attack ◽  
Significant Percentage ◽  
Clear Cut ◽  
New Approaches ◽  
Current Therapies

A significant percentage of individuals with migraine, by some estimates as many as 25%, are candidates for preventive therapy, also known as prophylactic therapy. These are treatments that are administered to pre-empt headache attacks, as opposed to acute treatments that are administered once a headache attack has occurred (although many treatments may be effective both as preventive and acute therapies). There are a variety of options for preventive therapy with widely varying mechanisms of action, and there is no clear-cut single choice for any individual patient. Preventive therapies can be broadly grouped as antihypertensive medications, anticonvulsant medications, antidepressants, vitamins, natural therapies, neurotoxins, and neuromodulation approaches. Early clinical trials indicate that antibody therapies may play an important role as future migraine preventive therapies. While current therapies are effective for some patients, there is a critical need for better means of identifying which strategy is the best for each individual patient, and also for new approaches that are more effective and better tolerated for prevention of migraine overall.

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