Surfactant therapy
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| Surfactant therapy | |
|---|---|
| Other names | Surfactant application, Surfactant replacement |
| Specialty | Neonatology |
Surfactant therapy is the medical administration of pulmonary surfactant that is derived from outside of the body. Pulmonary surfactant is a soap-like chemical synthesized by type II alveolar pneumocytes and is of various lipids (80% phospholipids, 5-10% cholesterol, and ∼10% surfactant-associated proteins). This biological fluid reduces surface tension and lines the aqueous layer covering the alveolar surface of the lung. For more details, see Pulmonary surfactant. [1][2][3]
Surfactant therapy, or surfactant replacement therapy, is used in situations where there is not sufficient fluid covering the lung. The most common use is in premature neonates or babies born with respiratory distress syndrome. Conditions adult respiratory distress syndrome or Hyaline Membrane Disease are also sometimes treated with exogenously derived surfactant. One of the more common uses of surfactant therapy is to treat alveolar surfactant deficiency in premature newborns. Most commonly, treatment is composed of multiple doses of 100 mg/kg of exogenous surfactant. [2]
Types of Surfactants
[edit]Poractant alfa, Calfactant, and Beractant are types of natural surfactants commercially available in the United States. Although data is sometimes conflicting, it appears that there are no significant differences among the available preparations.[citation needed]
LISA surfactant delivery in infants
[edit]The LISA (Less Invasive Surfactant Administration) method is much more effective in situations where the preterm infant is already breathing, and it has become a standard procedure in German hospitals.[4] Intubation via mechanical ventilation is less effective than the LISA method within the first 72 hours of birth.[5]
Respiratory Distress Syndrome
[edit]Exogenous surfactant replacement therapy is effective in reducing IRDS mortality and morbidity in preterm infants.[6][7][8][9]
Adult respiratory distress syndrome
[edit]Surfactant therapy is not used to treat adults with adult respiratory distress syndrome because the evidence regarding its effect on patient-important outcomes is inconsistent.
See also
[edit]References
[edit]- ^ Possmayer, Fred; Zuo, Yi Y.; Veldhuizen, Ruud A. W.; Petersen, Nils O. (2023-12-13). "Pulmonary Surfactant: A Mighty Thin Film". Chemical Reviews. 123 (23): 13209–13290. doi:10.1021/acs.chemrev.3c00146. ISSN 0009-2665.
- ^ a b Robertson, Bengt; Halliday, Henry L. (1998-11-19). "Principles of surfactant replacement". Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease. 1408 (2): 346–361. doi:10.1016/S0925-4439(98)00080-5. ISSN 0925-4439.
- ^ Dhar, Dipak Kumar; Majumder, Nilratan; Paul, Debasish (2016). "Assessment of Knowledge and Practice of Mothers of Children under Five regarding Zinc Therapy in Childhood Diarrhea". International Journal of Advanced and Integrated Medical Sciences. 1 (4): 169–172. doi:10.5005/jp-journals-10050-10055. ISSN 2456-2726.
- ^ Härtel, Christoph; Paul, Pia; Hanke, Kathrin; Humberg, Alexander; Kribs, Angela; Mehler, Katrin; Vochem, Matthias; Wieg, Christian; Roll, Claudia; Herting, Egbert; Göpel, Wolfgang (29 May 2018). "Less invasive surfactant administration and complications of preterm birth". Scientific Reports. 8 (1): 8333. Bibcode:2018NatSR...8.8333H. doi:10.1038/s41598-018-26437-x. PMC 5974027. PMID 29844331.
- ^ Lau, Christine S. M.; Chamberlain, Ronald S.; Sun, Shyan (24 March 2017). "Less Invasive Surfactant Administration Reduces the Need for Mechanical Ventilation in Preterm Infants". Global Pediatric Health. 4: 2333794X1769668. doi:10.1177/2333794X17696683. PMC 5433666. PMID 28540346.
- ^ Suresh, Gautham K; Soll, Roger F (21 April 2005). "Overview of Surfactant Replacement Trials". Journal of Perinatology. 25 (S2): S40–S44. doi:10.1038/sj.jp.7211320. PMID 15861172.
- ^ Fujiwara, Tetsuro; Chida, Shoichi; Watabe, Yoshitane; Maeta, Haruo; Morita, Tomoaki; Abe, Tadaaki (January 1980). "Artificial surfactant therapy in hyaline-membrane disease". The Lancet. 315 (8159): 55–59. doi:10.1016/s0140-6736(80)90489-4. PMID 6101413. S2CID 19170032.
- ^ Liechty, Edward A.; Donovan, Edward; Purohit, Dilip; Gilhooly, Joseph; Feldman, Bernard; Noguchi, Akihiko; Denson, Susan E.; Sehgal, Sabitha S.; Gross, Ian; Stevens, Dennis; Ikegami, Machiko; Zachman, Richard D.; Carrier, Steven T.; Gunkel, J. Harry; Gold, Alan J. (1 July 1991). "Reduction of Neonatal Mortality after Multiple Doses of Bovine Surfactant in Low Birth Weight Neonates with Respiratory Distress Syndrome". Pediatrics. 88 (1): 19–28. doi:10.1542/peds.88.1.19. PMID 2057268. S2CID 26067225.
- ^ Kendig, James W.; Notter, Robert H.; Cox, Christopher; Aschner, Judy L.; Benn, Steven; Bernstein, Richard M.; Hendricks-Munoz, Karen; Maniscalco, William M.; Metlay, Leon A.; Phelps, Dale L.; Sinkin, Robert A.; Wood, Beverly P.; Shapiro, Donald L. (1 November 1988). "Surfactant Replacement Therapy at Birth: Final Analysis of a Clinical Trial and Comparisons With Similar Trials". Pediatrics. 82 (5): 756–762. PMID 3054783.