Surfactant Delivery Is Crucial for Enhancing Function of Ex-Vivo Premature Sheep Lungs: A Feasibility Study.

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Pulmonology Pub Date : 2025-07-01 DOI:10.1002/ppul.71205

Richard Pasteka, Lisa Hufnagl, Vasil Vodenicharov, Alissa Blessing, Angelika Berger, Michael Wagner, Tobias Werther

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Abstract

Aim: To compare effects of bolus and aerosolization surfactant delivery methods and ventilatory support on improving ex-vivo premature sheep lung function.

Methods: 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.

Results: 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.

Conclusions: 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.

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表面活性剂对提高离体早产绵羊肺功能至关重要的可行性研究。

目的：比较表面活性物质给药方式和雾化给药方式以及通气支持对早产儿绵羊离体肺功能的影响。方法：采用xPULM肺模拟器对16只离体早产绵羊肺进行模拟，剔除试验中破裂的7只肺，分别对丸组6只和气雾剂组3只肺进行分析。表面活性剂（0.5 mL α α活性剂）通过丸状注射或雾化给药。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）。结果：表面活性剂显著增加VT(表面活性剂中位VT = 0.21 mL；结论：在离体早产绵羊肺中，表面活性剂给药是肺功能改善的主要驱动因素，而PEEP的影响较小。xPULM肺模拟器可以在自然呼吸过程中进行研究，同时避免与动物模型相关的伦理问题。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Pulmonology 医学-呼吸系统

CiteScore

6.00

自引率

12.90%

发文量

468

审稿时长

3-8 weeks

期刊介绍： Pediatric Pulmonology (PPUL) is the foremost global journal studying the respiratory system in disease and in health as it develops from intrauterine life though adolescence to adulthood. Combining explicit and informative analysis of clinical as well as basic scientific research, PPUL provides a look at the many facets of respiratory system disorders in infants and children, ranging from pathological anatomy, developmental issues, and pathophysiology to infectious disease, asthma, cystic fibrosis, and airborne toxins. Focused attention is given to the reporting of diagnostic and therapeutic methods for neonates, preschool children, and adolescents, the enduring effects of childhood respiratory diseases, and newly described infectious diseases. PPUL concentrates on subject matters of crucial interest to specialists preparing for the Pediatric Subspecialty Examinations in the United States and other countries. With its attentive coverage and extensive clinical data, this journal is a principle source for pediatricians in practice and in training and a must have for all pediatric pulmonologists.