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Effects of pulmonary surfactant combined with noninvasive positive pressure ventilation in neonates with respiratory distress syndrome

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World Journal of Clinical Cases 2024年第23期12卷 5366-5373页

作者： Ze-Ning Shi Xin Zhang Chun-Yuan Du Bing Zhao Shu-Gang Liu Department of Pediatrics Army Military Medical University Officer School Affiliated HospitalShijiazhuang 050000Hebei ProvinceChina Department of Anesthesiology Army Military Medical University Officer School Affiliated HospitalShijiazhuang 050000Hebei ProvinceChina Department of Gynecology and Obstetrics Army Military Medical University Officer School Affiliated HospitalShijiazhuang 050000Hebei ProvinceChina

BACKGROUND Neonatal respiratory distress syndrome(NRDS)is one of the most common diseases in neonatal intensive care units,with an incidence rate of about 7%among ***,it is a leading cause of neonatal death in hospitals in *** main mechanism of the disease is hypoxemia and hypercapnia caused by lack of surfactant AIM To explore the effect of pulmonary surfactant(PS)combined with noninvasive positive pressure ventilation on keratin-14(KRT-14)and endothelin-1(ET-1)levels in peripheral blood and the effectiveness in treating *** Altogether 137 neonates with respiratory distress syndrome treated in our hospital from April 2019 to July 2021 were *** these,64 control cases were treated with noninvasive positive pressure ventilation and 73 observation cases were treated with PS combined with noninvasive positive pressure *** expression of KRT-14 and ET-1 in the two groups was *** deaths,complications,and PaO_(2),PaCO_(2),and PaO_(2)/FiO_(2)blood gas indexes in the two groups were *** operating characteristic curve(ROC)analysis was used to determine the diagnostic value of KRT-14 and ET-1 in the treatment of *** The observation group had a significantly higher effectiveness rate than the control *** was no significant difference between the two groups in terms of neonatal mortality and adverse reactions,such as bronchial dysplasia,cyanosis,and shortness of *** treatment,the levels of PaO_(2)and PaO_(2)/FiO_(2)in both groups were significantly higher than before treatment,while the level of PaCO_(2)was significantly *** treatment,the observation group had significantly higher levels of PaO_(2)and PaO_(2)/FiO_(2)than the control group,while PaCO_(2)was notably lower in the observation *** treatment,the KRT-14 and ET-1 levels in both groups were significantly decreased compared with the pre-treatment *** observation group had a reduction of KRT-14 and ET-

关键词： pulmonary surfactant Non-invasive positive pressure ventilation Neonatal respiratory distress syndrome Keratin-14 Endothelin-1

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Effect of different ventilation methods combined with pulmonary surfactant on neonatal acute respiratory distress syndrome

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世界临床病例杂志 2023年第25期11卷 5878-5886页

作者： Qing Qing Ping Zha Li-Ying Dai Yang Wang Department of Pediatrics The First Affiliated Hospital of Anhui Medical UniversityHefei 230001Anhui ProvinceChina Department of Neonatology Anhui Provincial Children's HospitalHefei 230001Anhui ProvinceChina

BACKGROUND Acute respiratory distress syndrome precipitates is widespread pulmonary injury in impacted individuals,the neonatal respiratory distress syndrome(NRDS),primarily observed in preterm infants,represents a prevalent critical condition in neonatal clinical *** To investigate the clinical efficacy of various ventilation strategies combined with pulmonary surfactant(PS)therapy in the treatment of *** A total of 20 neonates diagnosed with respiratory distress syndrome,admitted between May 2021 and June 2022,were randomly assigned to either a research group or a control *** in the research group received treatment involving high-frequency oscillatory ventilation(HFOV)in conjunction with *** contrast,neonates in the control group were administered either controlled mechanical ventilation or synchronous intermittent mandatory ventilation,combined with *** blood samples from the neonates in both groups were collected before treatment,as well as 6 h,12 h,24 h,and 48 h *** samples underwent blood gas analysis,with measurements taken for pH value,partial pressures of oxygen(O_(2))and carbon ***,data was collected on the duration of ventilator use,length of hospitalization time,O_(2) treatment time,treatment outcomes,and complications of the *** From 6-48 h post-treatment,both groups demonstrated significant improvements in arterial blood pH and oxygen partial pressure,along with a significant decrease in carbon dioxide partial pressure compared to pre-treatment values(P0.05).However,the research group had significantly lower X-ray scores,shorter hospitalization time,and less time on O_(2) therapy compared to the control group(P0.05),but the research group had a significantly lower incidence of complications(P<

关键词： Neonatal respiratory distress syndrome pulmonary surfactant Mechanical ventilation Respiratory distress syndrome Acute respiratory distress syndrome

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Effects of continuous tracheal gas insufflation during pressure limited ventilation on pulmonary surfactant in rabbits with acute lung injury

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Chinese Medical Journal 2006年第17期119卷 1415-1420页

作者： ZHU Guang-fa ZHANG Wei ZONG Hua LIANG Ying Department of Respiratory Medicine Beijing Anzhen HospitalCapital University of Medical Science Beijing 100029 China

Background pulmonary surfactant dysfunction may contribute to the development of ventilator induced lung injury （VILI）. Tracheal gas insuffiation （TGI） is a technique in which fresh gas is introduced into the trachea and augment ventilation by reducing the dead space of ventilatory system, reducing ventilatory pressures and tidal volume （VT） while maintaining constant partial arterial CO2 pressure （PaCO2）. We hypothesised that TGI limited peak inspiratory pressure （PIP） and VT and would minimize conventional mechanical ventilation （CMV） induced pulmonary surfactant dysfunction and thereby attenuate VILI in rabbits with acute lung injury （ALI）. Methods ALI was induced by intratracheal administration of lipopolysaccharide in anaesthetized, ventilated healthy adult rabbits randomly assigned to continuous TGI at 0.5 L/min （TGI group） or CMV group （n=8 for each group）, and subsequently ventilated with limited PIP and VT to maintain PaCO2 within 35 to 45 mmHg for 4 hours. Physiological dead space to VT ratio （VD/VT）, dynamic respiratory compliance （Cdyn） and partial arterial O2 pressure （PaO2） were monitored. After ventilation, lungs were analysed for total phospholipids （TPL）, total proteins （TP）, pulmonary surfactant small to large aggregates ratio （SA/LA） in bronchoalveolar lavage fluid （BALF） and for determination of alveolar volume density （Vv）, myeloperoxidase and interleukin （IL）-8. Results TGI resulted in significant （P〈0.05 or P〈0.01） decrease in PIP [（22.4±1.8） cmH20 vs （29.5±1.1） cmH2O], VT [（6.9±1.3） ml/kg vs （9.8±1.11） ml/kg], VD/VT [（32±5）% vs （46±2）%], TP [（109±22） mg/kg vs （187±25） mg/kg], SA/LA （2.5±0.4 vs 5.4±0.7）, myeloperoxidase [（6.2±0.5） U/g tissue vs （12.3±0.8） U/g tissue] and IL-8 [（987±106） ng/g tissue vs （24±3） mN/m] of BALF, and significant （P〈0.05） increase in Cdyn [（0.47±0.02） ml·cmH2O^-1·kg^-1 vs （0.31±0.02） ml·cmH2O^-1·kg^-1], PaO2 [（175±24） mmHg vs （135±26） mmHg], TPL/TP （52±8 vs 33±11） and Vv （0.65±0.05 vs 0.44±0.07） as compared with CMV

关键词： tracheal gas insufflation acute lung injury pulmonary surfactant ventilator induced lung injury mechanical ventilation

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Changes of pulmonary surfactant Activities after Severe Steam Inhalation injury in Rabbits

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Military Medical Research 1986年第2期 109-116页

作者：刘志远黎鳌朱佩芳杨宗城水进堂 Third Miliitary Medical College Chongqing Burn Center First Teaching Hospital

PaO,lung water cotent,surface tension(in terms of hysteresis)andlecithin content of both the bronchial irrigation fluid and lung homogena-tes were determined after severe steam inhalation injury in *** with the decrease of PaOand the increase of lung water con-tent,there was a remarkable dropping of pulmonary surfactant activitiesas demonstrated by progressive increase of surface tension and decrease oflecithin content in bronchial irrigation fluid and *** is thusproposed that the dropping of pulmonary sarfactant activities plays an im-portant role in the pathogenesis of pulmonary edema after inhalation ***,successive determination of lecithint content and/or surfacetension of the bronchial irrigation fluid might serve as an early diagnos-tic as well as prognostic aid in severe inhalotion injury.

关键词： pulmonary surfactant inhalation injury lecithin content surface tension hysteresis hysteretic loop surface area-surface tension

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Isolation of Bovine pulmonary surfactant and Analysis of Its Chemical Composition and Physicochemical Properties

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Military Medical Research 1987年第1期 83-87页

作者：刘明耀张亚霏 Shanghai Department of Pathophysiology Second Military Medical College

Bovine pulmonary surfaetant was obtained by endotracheal lavage oflungs from newly slaughtered calves fallowed by differential *** of bovine surfactant contained 86.1±2.1% of phospholipids((?)±SD),1.8~±1.1% of protein,and smaller amounts of cholesterol,fatty acids,glyceridesand ***(83.4±5.6%)accounted for most of thephospholipids,of which disaturated pbosphatidylcholine was 76.0±4.7%.Thephysic(?)chemical properties of bovine sarfactant were measured with a modifiedWilhelmy film balance made by the *** minimum surface tension was2.4±1.5mN/m,stability index 1.78±*** eompressibility at 10mN/m0.022±0.004m/mN,and surface concentration of phospholipids at 10 mN/m1.112±0.283 nmol/cm~*** surfactant spread rapidly and could be quicklyadsorbed to the air liquid *** results show that the bovine pulmonarysurfactant we isolated is able to meet the criteria for investigations of surfactantreplacement therapy.

关键词： pulmonary surfactant replacement therapy film balance surface activity adsorption rate spreading rate

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Study on pulmonary surfactant of Sudden Death of Infant

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Journal of Nanjing Medical University 2000年第2期14卷 101-104页

作者：宋嘉振郭思侠 Department of Intensive Care Unit the First Affiliated Hospital of Nanjing Medical University Nanjing 210029 P.R. China Department of Pathology the Maternity and Infant Health Care Center of Nanjing Nanjing 210004 P. R. China

Objective To find the pathogenesis of sudden infant death syndrome (SIDS) from changes of pulmonary surfactant. Methods By means of thin layer chromatography technique, surfactant in whole lung specimens of 10 infants with SIDS and 10 control infants without SIDS (dead of nonrespiratory diseases) were examined qualitatively and quantitatively. Results Eleven components in pulmonary surfactant were examined qualitatively, including lysophosphatidylcholine, sphingomyelin, phosphatidylcholine, phosphatidylserine, phosphatidylinositol, phosphatidylethanolamine, phosphatidylglycerol, diphosphatidylglycerol, phosphatidic acid, cholesterol and neutral lipids. Quantitative examination showed that the amount of surfactant of whole lung specimens in sudden death group [(8.9±1.0) mg/g wet lung weight] was significantly less than that in control group [(12.6±1.4) mg/g wet lung weight, Ppulmonary surfactant in sudden death infants, with the amount decreasing and the ratio of its components being disturbed, which is one of the important pathogenies of SIDS.

关键词： sudden infant death syndrome pulmonary surfactant

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Ultrastructure and mechanical perturbation of pulmonary surfactants by inhaled carbon nanoparticles: a computer simulation study

Ultrastructure and mechanical perturbation of pulmonary surf...

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中国化学会-生物物理化学专业委员会第四届全国生物物理化学会议

作者：岳同涛黄方徐燕中国石油大学(华东)生物工程与技术中心

Carbon nanoparticles(CNPs), such as graphene nanosheets(GNs), carbon nanotubes(CNTs) and carbon nanospheres(CNSs), have displayed extraordinary mechanical, electrical and thermal properties. They accordingly have potential applications in diverse fields from energy conservation to disease therapy. In parallel, there is a general biosafety concern for human exposure of CNPs. Since human lung is easily accessible for CNPs, the increasing exposure of CNPs is putting human lungs at high risk. During respiration, inhaled CNPs are first captured by the pulmonary surfactant(PS) and disrupt its ultrastructure and mechanical property. With the aid of computer simulation techniques, we have investigated the interaction between PS and CNPs. For GNs, their pulmonary adsorption was found to rigidify the PS and thus inhibit its mechanical function. The internalization is generally accomplished via PS shape transformation and GN self-rotation. For CNTs, five different interaction pathways were identified by varying the aspect ratio. They are vertical insertion, horizontal translocation, lipid extraction, vesicle encapsulation and endocytic internalization. Each pathway displays unique behavior for PS perturbation. For CNSs, their aggregation in PS was found to be size dependent and mediated by lipid extractions. Future studies will be carried out by combining simulations and in vitro experiments to thoroughly understand the inhalation toxicity of more general nanoparticles. We hope that our studies can provide guidelines for developing effective strategies against the adverse effects of inhaled CNPs.

关键词： carbon nanoparticles inhalation toxicity pulmonary surfactant computer simulation

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Population-based frequency of surfactant dysfunction mutations in a native Chinese cohort

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世界儿科杂志:英文版 2016年第2期12卷 190-195页

作者： Yu-Jun Chen Jennifer Anne Wambach Kelcey DePass Daniel James Wegner Shao-Ke Chen Qun-Yuan Zhang Hillary Heins Francis Sessions Cole Aaron Hamvas Division of Neonatology Department of Pediatricsthe First Affi liated Hospital of Guangxi Medical UniversityNanningChina Division of Newborn Medicine Edward Mallinckrodt Department of PediatricsWashington University School of MedicineSt.LouisUSA Department of Pediatrics Guangxi Maternal and Child Health HospitalNanningChina Division of Statistical Genomics Department of GeneticsWashington University School of MedicineSt.LouisUSA

Background: Rare mutations in surfactant-associatedgenes contribute to neonatal respiratory distress *** frequency of mutations in these genes in the Chinesepopulation is ***: We obtained blood spots from the GuangxiNeonatal Screening Center in Nanning, China thatincluded Han (n=443) and Zhuang (n=313) ethnic *** resequenced all exons of the surfactant proteins-B(SFTPB), -C (SFTPC), and the ATP-binding cassettemember A3 (ABCA3) genes and compared the frequenciesof 5 common and all rare ***: We found minor differences in thefrequencies of the common variants in the Han andZhuang cohorts. We did not find any rare mutations inSFTPB or SFTPC, but we found three ABCA3 mutationsin the Han [minor allele frequency (MAF)=0.003] and 7 inthe Zhuang (MAF=0.011) cohorts (P=0.10). The ABCA3mutations were unique to each cohort;five were *** collapsed carrier rate of rare ABCA3 mutations inthe Han and Zhuang populations combined was 1.3%,which is signifi cantly lower than that in the United States(P<0.001).Conclusions: The population-based frequency ofmutations in ABCA3 in south China newborns is signifi cantlylower than that in United States. The contribution of theserare ABCA3 mutations to disease burden in the south Chinapopulation is still unknown.

关键词： genetic epidemiology human population genetics neonatal respiratory distress syndrome pulmonary surfactant

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Effects of Different surfactant Administrations on Cerebral Autoregulation in Preterm Infants with Respiratory Distress Syndrome

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2016年第6期36卷 801-805页

作者：李旭芳程婷婷关瑞莲梁红卢伟能张敬华刘美仪余欣梁俊孙黎张炼 Department of Neonatology Guangzhou Women and Children's Medical Center

To treat respiratory distress syndrome,surfactant is currently delivered via less invasive surfactant administration（LISA） or INtubation surfactant Extubation（INSURE）.The aim of this study was to compare the effect of the two delivery methods of surfactant on cerebral *** infrared spectroscopy monitoring was carried out to detect cerebral oxygen saturation（Sc O2）,and the mean arterial blood pressure（MABP） was simultaneously *** 44 preterm infants included,the surfactant was administrated to 22 via LISA and 22 via *** clinical characteristics,treatments and outcomes of the infants showed no significant differences between the two *** correlation coefficient of Sc O2 and MABP（rSc O2-MABP） 5 min before administration was similar in the two *** surfactant administration,rSc O2-MABP increased in both groups（0.44±0.10 to 0.54±0.12 in LISA,0.45±0.11 to 0.69±0.09 in INSURE）.In the first and second 5 min after instillation,rSc O2-MABP was not significantly different from baseline in the LISA group,but increased in the first 5 min after instillation（0.59±0.13,P=0.000 compared with the baseline in the same group） and recovered in the second 5 min after instillation（0.48±0.10,P=0.321） in the INSURE *** were significant differences in the change rates of rSc O2-MABP between the two groups during and after surfactant *** results suggest that cerebral autoregulation may be affected transiently by surfactant *** effect duration of LISA is shorter than that of INSURE（〈5 min in LISA vs.5–10 min in INSURE）.

关键词： preterm infant respiratory distress syndrome surfactant cerebral autoreguiation pulmonary surfactant

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surfactant Replacement Therapy for the Prevention of the Neonatal Respiratory Distress Syndrome in Preterm Infants

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中国当代儿科杂志 2001年第4期 482-486页

作者： ZHOU Xiao-Guang, LUO Xian-Qiong, YANG Lin-Lin, CHEN Yun-Bin, ZHANG Xiao-Zhuang, ZHAO Qing-GuoDepartment of Neonatology, Maternal and Child Health Hospital of Guangdong Province, Guangzhou 510010,China

Objective To study the efficacy of pulmonary surfactant (Exosurf) in the prevention of the neonatal respiratory distress syndrome (RDS) in preterm infants. Methods A prospective clinical trial was conducted. To prevent RDS, a single dose of pulmonary surfactant (Exosurf) was administered intratracheally in 25 preterm infants at a high risk of developing RDS as the prophylaxis group, and another 25 preterm babies who received no surfactant administration formed the control group. Results The preterm infants in the prophylaxis group received a prophylactic dose of surfactant ( 67.5 mg/kg) within 0.25 to 6 hours ( 3.4± 1.9 hours) after delivery. Oxygenation in these babies was markedly improved and their clinical symptoms were relieved after the administration of surfactant. The durations of supplemental oxygen administration, assisted ventilation and hospitalization in the prophylaxis group, were ( 9.5± 6.9) days, ( 2.6± 3.8) days and ( 40.8± 17.8) days respectively, which were significantly shortened compared with those of the control group (P 0.05). Conclusions Prophylactic administration of surfactant can improve oxygenation, relieve symptoms, and shorten the duration of supplemental oxygen administration, assisted ventilation and hospitalization. It has a relief effect on RDS in preterm infants.

关键词： Prematurity Respiratory distress syndrome pulmonary surfactant Prophylactic administration

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