Evidence map›Paper›PMID 37896128›Full record

ArticlePharmaceutics2023

Evaluation of a Novel Dry Powder Surfactant Aerosol Delivery System for Use in Premature Infants Supported with Bubble CPAP.

Robert M DiBlasi, Coral N Crandall, Rebecca J Engberg, Kunal Bijlani, Dolena Ledee, Masaki Kajimoto, Frans J Walther

Open access · goldAbstract read
In one paragraph

Article in Pharmaceutics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.6field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. What is new in synthetic lung surfactant protein technology?Expert review of respiratory medicine · 2024
    Article
  3. Moving on from clinical animal-derived surfactants to peptide-based synthetic pulmonary surfactant.American journal of physiology. Lung cellular and molecular physiology · 2024
    Review
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Robert M DiBlasiDepartment of Respiratory Care Therapy, Seattle Children's Hospital, Seattle, WA 98105, USA.
Coral N CrandallCenter for Respiratory Biology and Therapeutics, Seattle Children's Research Institute, Seattle, WA 98101, USA.ORCID 0000-0003-1404-2407
Rebecca J EngbergCenter for Respiratory Biology and Therapeutics, Seattle Children's Research Institute, Seattle, WA 98101, USA.
Kunal BijlaniMechanical Engineering, Zewski Corporation, Magnolia, TX 77354, USA.ORCID 0009-0006-7202-5735
Dolena LedeeDivision of Cardiology, Department of Pediatrics, University of Washington, Seattle, WA 98195, USA.ORCID 0000-0003-1041-4795
Masaki KajimotoCenter for Respiratory Biology and Therapeutics, Seattle Children's Research Institute, Seattle, WA 98101, USA.ORCID 0000-0001-9377-1354
Frans J WaltherDepartment of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA.ORCID 0000-0003-1931-159X
Seattle Children's Hospital · USUniversity of California, Los Angeles · USUniversity of Washington · US

Funding

Bill & Melinda Gates Foundation INV-003450 to RD, INV-040846 to FW
6 · The paper itself

Abstract

Aerosolized lung surfactant therapy during nasal continuous positive airway pressure (CPAP) support avoids intubation but is highly complex, with reported poor nebulizer efficiency and low pulmonary deposition. The study objective was to evaluate particle size, operational compatibility, and drug delivery efficiency with various nasal CPAP interfaces and gas humidity levels of a synthetic dry powder (DP) surfactant aerosol delivered by a low-flow aerosol chamber (LFAC) inhaler combined with bubble nasal CPAP (bCPAP). A particle impactor characterized DP surfactant aerosol particle size. Lung pressures and volumes were measured in a preterm infant nasal airway and lung model using LFAC flow injection into the bCPAP system with different nasal prongs. The LFAC was combined with bCPAP and a non-heated passover humidifier. DP surfactant mass deposition within the nasal airway and lung was quantified for different interfaces. Finally, surfactant aerosol therapy was investigated using select interfaces and bCPAP gas humidification by active heating. Surfactant aerosol particle size was 3.68 µm. Lung pressures and volumes were within an acceptable range for lung protection with LFAC actuation and bCPAP. Aerosol delivery of DP surfactant resulted in variable nasal airway (0-20%) and lung (0-40%) deposition. DP lung surfactant aerosols agglomerated in the prongs and nasal airways with significant reductions in lung delivery during active humidification of bCPAP gas. Our findings show high-efficiency delivery of small, synthetic DP surfactant particles without increasing the potential risk for lung injury during concurrent aerosol delivery and bCPAP with passive humidification. Specialized prongs adapted to minimize extrapulmonary aerosol losses and nasal deposition showed the greatest lung deposition. The use of heated, humidified bCPAP gases compromised drug delivery and safety. Safety and efficacy of DP aerosol delivery in preterm infants supported with bCPAP requires more research.

Indexed as

aerosol deliverybubble CPAPdry powder lung surfactanthumidificationnasal prongsnebulizerparticle sizepreterm infant airway modelsynthetic lung surfactant

Identifiers

PMID37896128
PMCPMC10609757
OpenAlexW4386996878

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.