Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. Fall 2014;50(3):91-5.

Surfactant Administration in Neonates: A Review of Delivery Methods

Affiliations
Free PMC article
Review

Surfactant Administration in Neonates: A Review of Delivery Methods

Nina Nouraeyan et al. Can J Respir Ther. .
Free PMC article

Abstract

Surfactant has revolutionized the treatment of respiratory distress syndrome and some other respiratory conditions that affect the fragile neonatal lung. Despite its widespread use, the optimal method of surfactant administration in preterm infants has yet to be clearly determined. The present article reviews several aspects of administration techniques that can influence surfactant delivery into the pulmonary airways: the bolus volume, injection rate, gravity and orientation, ventilation strategies, alveolar recruitment, and viscosity and surface tension of the fluid instilled. Based on the present review, knowledge gaps regarding the best way to administer surfactant to neonates remain. From the available evidence, however, the most effective way to optimize surfactant delivery and obtain a more homogeneous distribution of the drug is by using rapid bolus instillation in combination with appropriate alveolar recruitment techniques.

Le surfactant a révolutionné le traitement du syndrome de détresse respiratoire et d’autres troubles respiratoires qui endommagent le fragile poumon néonatal. Malgré l’utilisation généralisée du surfactant son mode optimal d’administration n’est pas clairement établi chez les nourrissons prématurés. Le présent article traite de divers aspects des techniques d’administration, qui peuvent influer sur la libération du surfactant dans les voies respiratoires : le volume du bolus, le rythme d’injection, la gravité et l’orientation, les stratégies de ventilation, le recrutement alvéolaire, ainsi que la viscosité et la tension de surface du liquide instillé. D’après la présente revue, il reste des lacunes quant au meilleur moyen d’administrer le surfactant aux nouveau-nés. Cependant, selon les données probantes, pour en optimiser l’administration et obtenir une distribution plus homogène, il est préférable de procéder à un bolus rapide, combiné à des techniques pertinentes de recrutement alvéolaire.

Keywords: Neonatology; Preterm infant; Respiratory distress syndrome; Review; Surfactant administration; Ventilation.

Similar articles

See all similar articles

Cited by 2 articles

References

    1. Polin RA, Carlo WA, Committee on Fetus and Newborn. American Academy of Pediatrics Surfactant replacement therapy for preterm and term neonates with respiratory distress. Pediatrics. 2014;133:156–63. - PubMed
    1. Jobe AH. Mechanisms to explain surfactant responses. Biol Neonate. 2006;89:298–302. - PubMed
    1. Tarawneh A, Kaczmarek J, Bottino MN, Sant’Anna GM. Severe airway obstruction during surfactant administration using a standardized protocol: A prospective, observational study. J Perinatol. 2012;32:270–5. - PubMed
    1. Fernandez-Ruanova MB, Alvarez FJ, Gastiasoro E, et al. Comparison of rapid bolus instillation with simplified slow administration of surfactant in lung lavaged rats. Pediatric Pulmonol. 1998;26:129–34. - PubMed
    1. Segerer H, van Gelder W, Angenent FW, et al. Pulmonary distribution and efficacy of exogenous surfactant in lung-lavaged rabbits are influenced by the instillation technique. Pediatr Res. 1993;34:490–4. - PubMed

LinkOut - more resources

Feedback