Cambridge Artificial Surfactant Trial

2015 ◽  
pp. 274-278 ◽  
Author(s):  
Colin Morley ◽  
Anne Greenough ◽  
Nigel Miller ◽  
Alec Bangham ◽  
Susan Wood ◽  
...  
Keyword(s):  
Artificial Surfactant

Effects of pharyngeal lubrication on the opening of obstructed upper airway

1992 ◽  
Vol 72 (6) ◽  
pp. 2311-2316 ◽  
Author(s):  
H. Miki ◽  
W. Hida ◽  
Y. Kikuchi ◽  
T. Chonan ◽  
M. Satoh ◽  
...  
Keyword(s):  
Hypoglossal Nerve ◽  
Muscle Tone ◽  
Upper Airway ◽  
Intraluminal Pressure ◽  
Lower Airway ◽  
Before And After ◽  
Airway Opening ◽  
Cervical Trachea ◽  
Artificial Surfactant ◽  
Stimulation Of

We examined the effect of electrical stimulation of the hypoglossal nerve and pharyngeal lubrication with artificial surfactant (Surfactant T-A) on the opening of obstructed upper airway in nine anesthetized supine dogs. The upper airway was isolated from the lower airway by transecting the cervical trachea. Upper airway obstruction was induced by applying constant negative pressures (5, 10, 20, and 30 cmH2O) on the rostral cut end of the trachea. Peripheral cut ends of the hypoglossal nerves were electrically stimulated by square-wave pulses at various frequencies from 10 to 30 Hz (0.2-ms duration, 5–7 V), and the critical stimulating frequency necessary for opening the obstructed upper airway was measured at each driving pressure before and after pharyngeal lubrication with artificial surfactant. The critical stimulation frequency for upper airway opening significantly increased as upper airway pressure became more negative and significantly decreased with lubrication of the upper airway. These findings suggest that greater muscle tone of the genioglossus is needed to open the occluded upper airway with larger negative intraluminal pressure and that lubrication of the pharyngeal mucosa with artificial surfactant facilitates reopening of the upper airway.

scholarly journals Artificial surfactant and natural surfactant. Comparative study of the effects on premature rabbit lungs.

1980 ◽  
Vol 55 (10) ◽  
pp. 758-765 ◽  
Author(s):  
C Morley ◽  
B Robertson ◽  
B Lachmann ◽  
R Nilsson ◽  
A Bangham ◽  
...  
Keyword(s):  
Comparative Study ◽  
Natural Surfactant ◽  
Artificial Surfactant

Synthetic surfactant scavenges oxidants and protects against hyperoxic lung injury

1994 ◽  
Vol 77 (3) ◽  
pp. 1217-1223 ◽  
Author(s):  
A. J. Ghio ◽  
P. J. Fracica ◽  
S. L. Young ◽  
C. A. Piantadosi
Keyword(s):  
Thiobarbituric Acid ◽  
Cetyl Alcohol ◽  
Synthetic Surfactant ◽  
Active Components ◽  
Lung Weight ◽  
Hyperoxic Lung Injury ◽  
Surface Active ◽  
Artificial Surfactant

Injury and mortality after exposure to 100% oxygen can be diminished by surfactants that may operate by mechanisms other than those responsible for surface tension effects. We tested the hypotheses that 1) synthetic surfactant and its components function as antioxidants in vitro and 2) decrements in hyperoxic injury after treatment with a surfactant and its components are associated with decreases in oxidative stress to the lung. A synthetic surfactant (Exosurf) and its non-surface-active components tyloxapol and cetyl alcohol were incubated in an iron-containing hydroxyl radical-generating system to determine their abilities to prevent oxidation of deoxyribose. Doses of tyloxapol, cetyl alcohol, and artificial surfactant diminished the absorbance of thiobarbituric acid-reactive products of deoxyribose. Similarly, tyloxapol, cetyl alcohol, and the surfactant decreased hydroxylated products of salicylate in the same system. Rats were instilled intratracheally with saline, tyloxapol, tyloxapol plus cetyl alcohol, or artificial surfactant and immediately exposed to air or 100% oxygen. After 61 h of oxygen exposure, pleural fluid volume and wet-to-dry lung weight ratios were decreased in animals treated with surfactant and/or its components. There were also decrements in thiobarbituric acid-reactive products of lung tissue. In separate experiments, mean survival of saline-treated rats exposed to 100% oxygen was 67.3 +/- 8.1 h and > 96 h for rats given the surfactant or its components. We conclude that tyloxapol, cetyl alcohol, and Exosurf can function as antioxidants in vitro and their in vivo instillation is associated with reduction in measures of hyperoxic injury, oxidized tissue products, and mortality.

Artificial Surfactant Administration in an Animal Model of Hydrocarbon Induced Pulmonary Toxicity

1996 ◽  
Vol 34 (1) ◽  
pp. 139-139 ◽  
Author(s):  
Rd Shih ◽  
M Mercurio ◽  
R Morasco ◽  
R S Hoffman ◽  
R S Weisman ◽  
...  
Keyword(s):  
Animal Model ◽  
Pulmonary Toxicity ◽  
Surfactant Administration ◽  
Artificial Surfactant

Pulmonary Hemorrhage Risk in Infants With a Clinically Diagnosed Patent Ductus Arteriosus: A Retrospective Cohort Study

PEDIATRICS ◽  
1994 ◽  
Vol 94 (5) ◽  
pp. 719-723 ◽  
Author(s):  
Jeffery Garland ◽  
Rosanne Buck ◽  
Michelle Weinberg
Keyword(s):  
Cohort Study ◽  
Patent Ductus Arteriosus ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Ductus Arteriosus ◽  
Ventilatory Support ◽  
Pulmonary Hemorrhage ◽  
Surfactant Therapy ◽  
Artificial Surfactant ◽  
Patent Ductus

Objective. To determine if an early, dinically detectable patent ductus arteriosus (FDA) was associated with pulmonary hemorrhage (PH) in infants who received rescue artificial surfactant therapy. Methods. This retrospective cohort study of 233 low birth weight infants (≤ 1700 g) who received artificial surfactant therapy for respiratory distress syndrome compared antenatal and postnatal characteristics of infants with PH and without PH. Pulmonary hemorrhage was defined by an onset of bright red blood from the endotracheal tube in quantities that resulted in increased ventilatory support and a new infiltrate on a chest radiograph. Results. Pulmonary hemorrhage occurred in 6% (15/233) of the infants. Thirty-three percent (5/15) of the infants with PH died within 14 days of the hemorrhage. Of the 15 PH, 73% occurred within 48 hours of the first surfactant dose. Pulmonary hemorrhage was more common in male infants and infants of mothers who received antibiotic therapy during labor (P ≤ .04). Infants with PH received surfactant earlier than those without PH (P = .04). Nursery events or therapies occurring following surfactant therapy that were associated with PH included: little improvement in ventilatory efficiency index (P = .01), dopamine infusion (P = .04), and the presence of a clinically detectable PDA before, or at the time of, the PH [60% (9/15) vs 33% (71/217), P = .03]. After adjusting for severity of illness before surfactant therapy, risk of PH remained greater in infants who developed symptoms of a PDA. Dopamine support appeared to modify the association between PDA and PH. Conclusions. In this retrospective cohort study, pulmonary hemorrhage was associated with the presence of a clinically detectable patent ductus arteriosus before, or at the time of, pulmonary hemorrhage.

On Replacing the Surfactant

PEDIATRICS ◽  
1980 ◽  
Vol 65 (6) ◽  
pp. 1176-1177
Author(s):  
Mary Ellen Avery
Keyword(s):  
Endotracheal Tube ◽  
Blood Gases ◽  
Hyaline Membrane Disease ◽  
Surfactant Deficiency ◽  
Hyaline Membrane ◽  
Surface Active ◽  
Artificial Surfactant ◽  
Patent Ductus

Ever since it was realized that hyaline membrane disease was the consequence of surfactant deficiency, replacing the missing surface-active alveolar lining layer has been a tantalizing prospect. The report of Fujiwara et al1 is the first demonstration in the human of consistent and dramatic success after a single instillation of an artificial surfactant by way of an endotracheal tube. The prompt restoration of a stable alveolar lining layer and the impressive improvement in blood gases are well documented. The problem of the widely patent ductus producing difficulties in the subsequent days is expected and of course could be approached by other interventions.

Two cases: Situations for artificial surfactant, beyond prematurity

2020 ◽  
Vol 25 (3) ◽  
pp. 112
Author(s):  
TimothyM Wehner ◽  
Laura Noack ◽  
JKerry MacDonald
Keyword(s):  
Artificial Surfactant

A synthetic surfactant based on a poly-Leu SP-C analog and phospholipids: effects on tidal volumes and lung gas volumes in ventilated immature newborn rabbits

2003 ◽  
Vol 95 (5) ◽  
pp. 2055-2063 ◽  
Author(s):  
Jan Johansson ◽  
Margareta Some ◽  
Britt-Marie Linderholm ◽  
Andreas Almlén ◽  
Tore Curstedt ◽  
...  
Keyword(s):  
Palmitic Acid ◽  
Distress Syndrome ◽  
Newborn Infants ◽  
Surfactant Protein ◽  
Synthetic Surfactant ◽  
Airway Epithelial ◽  
Phosphoryl Choline ◽  
Gas Volume ◽  
Artificial Surfactant ◽  
Newborn Animals

Available surfactants for treatment of respiratory distress syndrome in newborn infants are derived from animal lungs, which limits supply and poses a danger of propagating infectious material. Poly-Val→poly-Leu analogs of surfactant protein (SP)-C can be synthesized in large quantities and exhibit surface activity similar to SP-C. Here, activity of synthetic surfactants containing a poly-Leu SP-C analog (SP-C33) was evaluated in ventilated premature newborn rabbits. Treatment with 2.5 ml/kg body wt of 2% (wt/wt) SP-C33 in 1,2-dipalmitoyl- sn-3-glycero phosphoryl choline (DPPC)-1-palmitoyl-2-oleoyl- sn-3-glycero phosphoryl choline (POPC)-1-palmitoyl-2-oleoyl- sn-3-glycero phosphoryl glycerol (POPG), 68:0:31, 68:11:20, or 68:16:15 (wt/wt/wt) suspended at 80 mg/ml gave tidal volumes (Vt) of 20-25 ml/kg body wt, with an insufflation pressure of 25 cmH2O and no positive end-expiratory pressure (PEEP), comparable to the Vt for animals treated with the porcine surfactant Curosurf. Nontreated littermates had a Vt of ∼2 ml/kg body wt. The Vt for SP-C33 in DPPC-egg phosphatidylglycerol-palmitic acid [68:22:9 (wt/wt/wt)], DPPC-POPG-palmitic acid [68:22:9 (wt/wt/wt)], and DPPC-POPC-POPG [6:2:2 (wt/wt/wt)] was 15-20 ml/kg body wt. Histological examination of lungs from animals treated with SP-C33-based surfactants showed incomplete, usually patchy air expansion of alveolar spaces associated with only mild airway epithelial damage. Lung gas volume after 30 min of mechanical ventilation were more than threefold larger in animals treated with Curosurf than in those receiving SP-C33 in DPPC-POPC-POPG, 68:11:20. This difference could be largely counterbalanced by ventilation with PEEP (3-4 cmH2O). An artificial surfactant based on SP-C33 improves Vt in immature newborn animals ventilated with standardized peak pressure but requires PEEP to build up adequate lung gas volumes.

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