scholarly journals Exogenous surfactant in the treatment of neonatal meconium aspiration syndrome

2015 ◽  
Vol 01 (02) ◽  
pp. 049-060
Author(s):  
Andrea Calkovska ◽  
Daniela Mokra
Keyword(s):  
Meconium Aspiration Syndrome ◽  
Exogenous Surfactant ◽  
Meconium Aspiration

scholarly journals Recombinant Human Superoxide Dismutase and N-Acetylcysteine Addition to Exogenous Surfactant in the Treatment of Meconium Aspiration Syndrome

Molecules ◽  
2019 ◽  
Vol 24 (5) ◽  
pp. 905 ◽  
Author(s):  
Jana Kopincova ◽  
Maros Kolomaznik ◽  
Pavol Mikolka ◽  
Petra Kosutova ◽  
Juliana Topercerova ◽  
...  
Keyword(s):  
Superoxide Dismutase ◽  
Efficiency Index ◽  
Meconium Aspiration Syndrome ◽  
Mitogen Activated Protein Kinase ◽  
Exogenous Surfactant ◽  
Duration Of Treatment ◽  
Pulmonary Tissue ◽  
Meconium Aspiration ◽  
Oxidative Markers ◽  
Mitogen Activated Protein

This study aimed to evaluate the molecular background of N-acetylcysteine (NAC) and recombinant human superoxide dismutase (rhSOD) antioxidant action when combined with exogenous surfactant in the treatment of meconium aspiration syndrome (MAS), considering redox signalling a principal part of cell response to meconium. Young New Zealand rabbits were instilled with meconium suspension (Mec) and treated by surfactant alone (Surf) or surfactant in combination with i.v. NAC (Surf + NAC) or i.t. rhSOD (Surf + SOD), and oxygen-ventilated for 5 h. Dynamic lung-thorax compliance, mean airway pressure, PaO2/FiO2 and ventilation efficiency index were evaluated every hour; post mortem, inflammatory and oxidative markers (advanced oxidation protein products, total antioxidant capacity, hydroxynonenal (HNE), p38 mitogen activated protein kinase, caspase 3, thromboxane, endothelin-1 and secretory phospholipase A2) were assessed in pulmonary tissue homogenates. rhSOD addition to surfactant improved significantly, but transiently, gas exchange and reduced levels of inflammatory and oxidative molecules with higher impact; Surf + NAC had stronger effect only on HNE formation, and duration of treatment efficacy in respiratory parameters. In both antioxidants, it seems that targeting reactive oxygen species may be strong supporting factor in surfactant treatment of MAS due to redox sensitivity of many intracellular pathways triggered by meconium.

scholarly journals Lung Inflammatory and Oxidative Alterations After Exogenous Surfactant Therapy Fortified With Budesonide in Rabbit Model of Meconium Aspiration Syndrome

2016 ◽  
pp. S653-S662 ◽  
Author(s):  
P. MIKOLKA ◽  
J. KOPINCOVÁ ◽  
P. KOŠÚTOVÁ ◽  
D. ČIERNY ◽  
A. ČALKOVSKÁ ◽  
...  
Keyword(s):  
Oxidative Damage ◽  
Expression Profiles ◽  
Rabbit Model ◽  
Weight Ratio ◽  
Meconium Aspiration Syndrome ◽  
Exogenous Surfactant ◽  
Lung Edema ◽  
Edema Formation ◽  
Meconium Aspiration ◽  
Cell Counts

Meconium aspiration syndrome (MAS) triggers inflammatory and oxidative pathways which can inactivate both pulmonary surfactant and therapeutically given exogenous surfactant. Glucocorticoid budesonide added to exogenous surfactant can inhibit inflammation and thereby enhance treatment efficacy. Neonatal meconium (25 mg/ml, 4 ml/kg) was administered intratracheally (i.t.) to rabbits. When the MAS model was prepared, animals were treated with budesonide i.t. (Pulmicort, 0.25 mg/kg, M+B); with surfactant lung lavage (Curosurf®, 10 ml/kg, 5 mg phospholipids/ml, M+S) followed by undiluted Curosurf® i.t. (100 mg phospholipids/kg); with combination of budesonide and surfactant (M+S+B); or were untreated (M); or served as controls with saline i.t. instead of meconium (C). Animals were oxygen-ventilated for additional 5 h. Cell counts in the blood and bronchoalveolar lavage fluid (BAL), lung edema formation (wet/dry weight ratio), oxidative damage of lipids/ proteins and inflammatory expression profiles (IL-2, IL-6, IL-13, TNF-α) in the lung homogenate and plasma were determined. Combined surfactant+budesonide therapy was the most effective in reduction of neutrophil counts in BAL, oxidative damage, levels and mRNA expression of cytokines in the lung, and lung edema formation compared to untreated animals. Curosurf fortified with budesonide mitigated lung inflammation and oxidative modifications what indicate the perspectives of this treatment combination for MAS therapy.

POLYETHYLENE GLYCOL ADDITION DOES NOT IMPROVE EXOGENOUS SURFACTANT FUNCTION IN AN EXPERIMENTAL MODEL OF MECONIUM ASPIRATION SYNDROME

2009 ◽  
Vol 35 (1) ◽  
pp. 76-88 ◽  
Author(s):  
Joao Cesar Lyra ◽  
Renata Suman Mascaretti ◽  
Alexander Roberto Precioso ◽  
Luciana Branco Haddad ◽  
Thais Mauad ◽  
...  
Keyword(s):  
Polyethylene Glycol ◽  
Experimental Model ◽  
Meconium Aspiration Syndrome ◽  
Exogenous Surfactant ◽  
Meconium Aspiration

scholarly journals N-Acetylcysteine Advancement of Surfactant Therapy in Experimental Meconium Aspiration Syndrome: Possible Mechanisms

2014 ◽  
pp. S629-S642 ◽  
Author(s):  
J. KOPINCOVÁ ◽  
D. MOKRÁ ◽  
P. MIKOLKA ◽  
M. KOLOMAZNÍK ◽  
A. ČALKOVSKÁ
Keyword(s):  
Oxidative Damage ◽  
Therapeutic Effect ◽  
Neutrophil Migration ◽  
Oxygenation Index ◽  
Meconium Aspiration Syndrome ◽  
Surfactant Therapy ◽  
Total Leukocyte Count ◽  
Exogenous Surfactant ◽  
Meconium Aspiration ◽  
Respiratory Parameters

Meconium aspiration syndrome (MAS) is meconium-induced respiratory failure of newborns associated with activation of inflammatory and oxidative pathways. For severe MAS, exogenous surfactant treatment is used which improves respiratory functions but does not treat the inflammation. Oxidative process can lead to later surfactant inactivation; hence, surfactant combination with antioxidative agent may enhance the therapeutic effect. Young New Zealand rabbits were instilled by meconium suspension and treated by surfactant alone, N-acetylcysteine (NAC) alone or by their combination and oxygen-ventilated for 5 h. Blood samples were taken before and 30 min after meconium application and 30 min, 1, 3 and 5 h after the treatment for evaluating of oxidative damage, total leukocyte count, leukocyte differential count and respiratory parameters. Leukocyte differential was assessed also in bronchoalveolar lavage fluid. NAC alone had only mild therapeutic effect on MAS. However, the combination of NAC and surfactant facilitated rapid onset of therapeutic effect in respiratory parameters (oxygenation index, PaO2/FiO2) compared to surfactant alone and was the only treatment which prevented neutrophil migration into the lungs, oxidative damage and lung edema. Moreover, NAC suppressed IL-8 and IL-β formation and thus seems to be favorable agent for improving surfactant therapy in MAS.

Airway lavage with exogenous surfactant in an animal model of meconium aspiration syndrome

2005 ◽  
Vol 47 (3) ◽  
pp. 237-241 ◽  
Author(s):  
Erquan Zhang ◽  
Takehiko Hiroma ◽  
Takeshi Sahashi ◽  
Atsuko Taki ◽  
Tatsuya Yoda ◽  
...  
Keyword(s):  
Animal Model ◽  
Meconium Aspiration Syndrome ◽  
Exogenous Surfactant ◽  
Meconium Aspiration

Exogenous surfactant improves lung compliance and oxygenation in adult rats with meconium aspiration

1994 ◽  
Vol 77 (4) ◽  
pp. 1961-1971 ◽  
Author(s):  
B. Sun ◽  
E. Herting ◽  
T. Curstedt ◽  
B. Robertson
Keyword(s):  
Lavage Fluid ◽  
Saline Group ◽  
Meconium Aspiration Syndrome ◽  
Lung Compliance ◽  
Exogenous Surfactant ◽  
High Dose ◽  
Adult Rats ◽  
Meconium Aspiration ◽  
Adult Rat ◽  
Arterial Po2

We studied the effects of exogenous surfactant on lung function and morphology in an adult rat model of severe meconium aspiration syndrome. Animals ventilated with 100% oxygen received 4–6 ml of human meconium (25 mg/ml) intratracheally. After 30 min, lung-thorax compliance had decreased by > 30% and arterial PO2 was < 10 kPa. Animals were then treated with no material (MECO group), 0.9% NaCl (MECO-saline group), natural porcine surfactant (NPS group) at a dose of 100 mg/kg, or modified porcine surfactant at a dose of either 100 (MPS100 group) or 200 mg/kg (MPS200 group) and were ventilated for another 180 min. Immediate and sustained improvement of arterial PO2 and compliance was observed in the MPS200 group, whereas the MPS100 and NPS groups showed less pronounced effects. There was a significant improvement of quasi-static lung volumes at maximum insufflation pressure and during deflation in the MPS200, MPS100, and NPS groups. Recordings with Wilhelmy balance showed that minimum surface tension of bronchoalveolar lavage fluid from animals receiving either type or dose of surfactant was significantly lower than in the MECO and MECO-saline groups. Meconium aspiration induced diffuse and prominent atelectasis, intra-alveolar edema, and hyaline membranes. These morphological abnormalities were reversed by exogenous surfactant, especially by the high-dose regimen.

Improved oxygenation with exogenous surfactant administration in experimental meconium aspiration syndrome

1994 ◽  
Vol 17 (2) ◽  
pp. 75-80 ◽  
Author(s):  
K. Bakeer Al-Mateen ◽  
Kimberly Dailey ◽  
Margaret M. Grimes ◽  
Gary R. Gutcher
Keyword(s):  
Meconium Aspiration Syndrome ◽  
Exogenous Surfactant ◽  
Meconium Aspiration ◽  
Surfactant Administration

scholarly journals Budesonide Added to Modified Porcine Surfactant Curosurf May Additionally Improve the Lung Functions in Meconium Aspiration Syndrome

2013 ◽  
pp. S191-S200 ◽  
Author(s):  
P. MIKOLKA ◽  
D. MOKRÁ ◽  
J. KOPINCOVÁ ◽  
L. TOMČÍKOVÁ-MIKUŠIAKOVÁ ◽  
A. ČALKOVSKÁ
Keyword(s):  
Combined Therapy ◽  
Weight Ratio ◽  
Lung Lavage ◽  
Meconium Aspiration Syndrome ◽  
Exogenous Surfactant ◽  
Lung Edema ◽  
Lung Weight ◽  
Edema Formation ◽  
Meconium Aspiration ◽  
Lung Functions

Severe meconium aspiration syndrome (MAS) in newborns is often treated by exogenous surfactant. Because its efficacy is reduced by meconium-induced inflammation, glucocorticoid budesonide was added into surfactant preparation Curosurf to enhance efficacy of the surfactant therapy in experimental model of MAS. Oxygen-ventilated rabbits were intratracheally given meconium (25 mg/ml, 4 ml/kg) to induce respiratory failure. Thirty minutes later, animals were treated by intratracheal budesonide (0.25 mg/kg) or surfactant lung lavage (10 ml/kg, 5 mg phospholipids/ml) repeated twice, followed by undiluted Curosurf (100 mg phospholipids/kg) or by the above mentioned surfactant treatment with the last surfactant dose fortified with budesonide (0.25 mg/kg) or were untreated. Animals were ventilated for additional 5 hours and respiratory parameters were measured regularly. After sacrificing animals, wet-dry lung weight ratio was evaluated and plasma levels of interleukins (IL)-1beta, -6, -8, and TNF-alpha were measured by ELISA method. Efficacy of the given therapies to enhance lung functions and to diminish lung edema formation and inflammation increased from budesonide-only and surfactant-only therapy to surfactant+budesonide therapy. Combined therapy improved gas exchange from 30 min of administration, and showed a longer-lasting effect than surfactant-only therapy. In conclusions, budesonide additionally improved the effects of exogenous surfactant in experimental MAS.

scholarly journals Randomized Trial of Oxygen Saturation Targets during and after Resuscitation and Reversal of Ductal Flow in an Ovine Model of Meconium Aspiration and Pulmonary Hypertension

Children ◽  
2021 ◽  
Vol 8 (7) ◽  
pp. 594
Author(s):  
Amy L. Lesneski ◽  
Payam Vali ◽  
Morgan E. Hardie ◽  
Satyan Lakshminrusimha ◽  
Deepika Sankaran
Keyword(s):  
Blood Flow ◽  
Pulmonary Hypertension ◽  
Oxygen Saturation ◽  
Ductus Arteriosus ◽  
Neonatal Resuscitation ◽  
Meconium Aspiration Syndrome ◽  
Ovine Model ◽  
Neurodevelopmental Outcomes ◽  
Meconium Aspiration ◽  
Blood Flows

Neonatal resuscitation (NRP) guidelines suggest targeting 85–95% preductal SpO2 by 10 min after birth. Optimal oxygen saturation (SpO2) targets during resuscitation and in the post-resuscitation management of neonatal meconium aspiration syndrome (MAS) with persistent pulmonary hypertension (PPHN) remains uncertain. Our objective was to compare the time to reversal of ductal flow from fetal pattern (right-to-left), to left-to-right, and to evaluate pulmonary (QPA), carotid (QCA)and ductal (QDA) blood flows between standard (85–94%) and high (95–99%) SpO2 targets during and after resuscitation. Twelve lambs asphyxiated by endotracheal meconium instillation and cord occlusion to induce MAS and PPHN were resuscitated per NRP guidelines and were randomized to either standard (85–94%) or high (95–99%) SpO2 targets. Out of twelve lambs with MAS and PPHN, six each were randomized to standard and high SpO2 targets. Median [interquartile range] time to change in direction of blood flow across the ductus arteriosus from right-to-left, to left-to-right was significantly shorter with high SpO2 target (7.4 (4.4–10.8) min) compared to standard SpO2 target (31.5 (21–66.2) min, p = 0.03). QPA was significantly higher during the first 10 min after birth with higher SpO2 target. At 60 min after birth, the QPA, QCA and QDA were not different between the groups. To conclude, targeting SpO2 of 95–99% during and after resuscitation may hasten reversal of ductal flow in lambs with MAS and PPHN and transiently increase QPA but no differences were observed at 60 min. Clinical studies comparing low and high SpO2 targets assessing hemodynamics and neurodevelopmental outcomes are warranted.

Sign in / Sign up

Export Citation Format

Share Document