Nebulizing poractant alfa versus conventional instillation: Ultrastructural appearance and preservation of surface activity

Authors:
Publisher website
Google Scholar
Abstract
Summary Background Nebulized surfactant therapy has been proposed as an alternative method of surfactant administration. The use of a perforated vibrating membrane nebulizer provides a variety of advantages over conventional nebulizers. We investigated the molecular structure and integrity of poractant alfa pre‐ and post‐nebulization. Method Curosurf® was nebulized using an Investigational eFlow® Nebulizer System. Non‐nebulized surfactant (“NN”), recollected surfactant droplets from nebulization through an endotracheal tube (“NT”) and nebulization of surfactant directly onto a surface (“ND”) were investigated by transmission electron microscopy. Biophysical characteristics were assessed by the Langmuir–Wilhelmy balance and the Captive Bubble Surfactometer. Results Volume densities of lamellar body‐like forms (LBL) and multi‐lamellar forms (ML) were high for “NN” and “NT” samples (38.8% vs. 47.7% for LBL and 58.2% vs. 47.8% for ML). In the “ND” sample, we found virtually no LBL's, ML's (72.6%) as well as uni‐lamellar forms (16.4%) and a new structure, the “garland‐like” forms (9.4%). Surface tension for “NN” and “NT” was 23.33 ± 0.29 and 25.77 ± 1.12 mN/m, respectively. Dynamic compression–expansion cycling minimum surface tensions were between 0.91 and 1.77 mN/m. Conclusion The similarity of surfactant characteristics of nebulized surfactant via a tube and the non‐nebulized surfactant suggests that vibrating membrane nebulizers are suitable for surfactant nebulization. Alterations in surfactant morphology and characteristics after nebulization were transient. A new structural subtype of surfactant was identified. Pediatr Pulmonol.

This publication has 27 references indexed in Scilit: