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Updated: Apr 16, 2026
Development of a Neonatal Piglet Acute Lung Injury Model Recreating the Early Environment of Preterm Infant Lungs
Published on: October 31, 2025
Lung deposition of nebulized surfactant in newborn piglets
Rikard Linner1, Valeria Perez-de-Sa, Doris Cunha-Goncalves
1Department of Cardiothoracic Anesthesia and Intensive Care, Lund University, Skåne University Hospital, Lund, Sweden.
Background:
It would be advantageous for the treatment of neonatal respiratory distress syndrome if effective amounts of surfactant could be delivered by nebulization.
Objective:
To investigate lung deposition and distribution of nebulized porcine surfactant using an investigational eFlow neonatal nebulizer.
Methods:
While lying on one side, 1-day-old piglets inhaled 200 mg·kg(-1) of nebulized surfactant via mask, nasal prongs, or tracheal tube. The surfactant was diluted with normal saline to 40 mg·ml(-1) and labeled with (99m)technetium-labelled nanocolloid. Undiluted surfactant (80 mg·ml(-1)) was instilled tracheally in a fourth group. Each group had 8 animals. Lung deposition was measured by gamma scintigraphy, and deposition values were presented as a percentage of the nebulized or instilled dose.
Results:
The median lung deposition of inhaled surfactant was 5% (range 3-16) via mask, 14% (2-40) via prongs, and 45% (25-56) via tracheal tube (p < 0.05). It was 88% (71-96) with instillation. In all groups, the surfactant preferentially went to the dependent lung. Deposition ratios (upper lung/both lungs) were 0.32 (0.13-0.58), 0.15 (0.05-0.58), 0.16 (0.11-0.23), and 0.08 (0.03-0.46).
Conclusions:
Using this nebulizer, the lung depositions of porcine surfactant were 45% via endotracheal tube and 14% via nasal-continuous positive airway pressure (prongs). These figures might be physiologically relevant, but still have to be confirmed in efficacy studies.
