For infants born with respiratory distress syndrome (RDS), liquid bolus delivery of surfactant administered through an endotracheal tube is common practice. While this method is generally effective, complications such as transient hypoxia, hypercapnia, and altered cerebral blood flow may occur. Aerosolized surfactant therapy has been explored as an alternative. Unfortunately, past efforts have led to disappointing results as aerosols were generated outside the lungs with significant pharyngeal deposition and minimal intrapulmonary instillation. A novel aerosol generator (Microjet™) is evaluated herein for intrapulmonary aerosol generation within an endotracheal tube and tested with Curosurf and Infasurf surfactants. Compared with other aerosol delivery devices, this process utilizes low air flow (range 0.01–0.2 L min−1) that is ideal for limiting potential barotrauma to the premature newborn lung. The mass mean diameter (MMD) of the particles for both tested surfactants was less than 4 μm, which is ideal for both uniform and distal lung delivery. As an indicator of phospholipid function, surfactant surface tension was measured before and after aerosol formation—with no significant difference. Moreover, this device has an outside diameter of <1 mm, which permits insertion into an endotracheal tube (of even 2.0 mm). In the premature infant where intravenous access is either technically challenging or difficult, aerosol drug delivery may provide an alternative route in patient resuscitation, stabilization, and care. Other potential applications of this type of device include the delivery of nutrients, antibiotics, and analgesics via the pulmonary route. Copyright 2015 American Association for Aerosol Research

中文翻译：

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肺内气溶胶生成和输送装置的体外评价

对于出生时患有呼吸窘迫综合征 (RDS) 的婴儿，通过气管插管注射表面活性剂是常见的做法。虽然这种方法通常是有效的，但可能会出现诸如短暂缺氧、高碳酸血症和脑血流量改变等并发症。已经探索了雾化表面活性剂疗法作为替代方案。不幸的是，过去的努力导致了令人失望的结果，因为气溶胶是在肺外产生的，咽部沉积显着，肺内滴注很少。本文评估了新型气溶胶发生器 (Microjet™) 在气管插管内产生的肺内气溶胶，并使用 Curosurf 和 Infasurf 表面活性剂进行测试。与其他气溶胶输送装置相比，该过程利用低气流（范围 0.01–0. 2 L min−1)，这是限制早产新生儿肺潜在气压伤的理想选择。两种测试表面活性剂的颗粒质量平均直径 (MMD) 均小于 4 μm，这对于均匀和远端肺递送都是理想的。作为磷脂功能的指标，在​​气溶胶形成之前和之后测量了表面活性剂表面张力——没有显着差异。此外，该装置的外径 <1 毫米，允许插入气管插管（甚至 2.0 毫米）。在静脉通路技术上具有挑战性或困难的早产儿中，气雾给药可能为患者复苏、稳定和护理提供替代途径。此类设备的其他潜在应用包括通过肺部途径输送营养物质、抗生素和镇痛剂。