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Surfactant delivery strategies to prevent bronchopulmonary dysplasia

Angela Kribs1, Kari D Roberts2, Daniele Trevisanuto3

  • 1Division of Neonatology, Department of Paediatrics, University of Cologne, Faculty of medicine, Cologne, Germany.

Seminars in Perinatology
|October 7, 2023
PubMed

Insights

Bronchopulmonary dysplasia (BPD) is a serious risk for preterm infants, influenced by antenatal factors and respiratory support. Alternative surfactant delivery methods while on continuous positive airway pressure (CPAP) may help prevent BPD.

Area of Science:

  • Neonatal Medicine
  • Pediatric Respiratory Medicine
  • Perinatal Research

Background:

  • Bronchopulmonary dysplasia (BPD) is a significant complication in preterm infants, often linked to antenatal factors and respiratory support strategies.
  • Respiratory distress syndrome (RDS) treatment with oxygen and positive pressure ventilation increases BPD risk.
  • Continuous positive airway pressure (CPAP) can reduce mechanical ventilation but may delay essential surfactant therapy for RDS.

Approach:

  • This review examines alternative surfactant delivery methods compatible with CPAP.
  • Investigated strategies include nebulization, pharyngeal instillation, and delivery via supraglottic airways or thin catheters.
  • The review synthesizes available data on the efficacy of these approaches.

Key Points:

  • Alternative surfactant delivery methods aim to provide RDS treatment benefits during CPAP support.
  • These strategies may mitigate the risks associated with prolonged positive pressure ventilation.
  • Evaluating the effectiveness of these novel delivery systems is crucial for BPD prevention.

Conclusions:

  • Alternative surfactant delivery during CPAP offers a promising avenue for reducing BPD incidence in preterm infants.
  • Further research is needed to solidify the evidence base for these innovative therapeutic approaches.
  • Optimizing respiratory support and surfactant administration is key to improving outcomes for vulnerable preterm neonates.

Keywords:
None

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