Surfactant administration in neonates: A review of delivery methods

Este artigo revisa os vários aspectos das técnicas  de administração de surfactante que podem influenciar a liberação desta droga dentro do pulmão. A melhor distribuição do surfactante reflete diretamente na melhor resposta do recém-nascido à droga. Os autores concluíram que a melhor forma de otimizar a aplicação do surfactante é aplica-lo de forma rápida e em bolus, mas sempre precedido de  técnicas adequadas de recrutamento pulmonar.

NOURAEYAN, N; LAMBRINAKOS, Raymond A; LEONE, M. et al. Surfactant administration in neonates: A review of delivery methods. Can J Respir Ther. 2014 Fall;50(3):91-5.

Surfactant has revolutionized the treatment of respiratory distress syndrome and some other respiratory conditions that affect the fragile neonatal lung. Despite its widespread use, the optimal method of surfactant administration in preterm infants has yet to be clearly determined. The present article reviews several aspects of administration techniques that can influence surfactant delivery into the pulmonary airways: the bolus volume, injection rate, gravity and orientation, ventilation strategies, alveolar recruitment, and viscosity and surface tension of the fluid instilled. Based on the present review, knowledge gaps regarding the best way to administer surfactant to neonates remain. From the available evidence, however, the most effective way to optimize surfactant delivery and obtain a more homogeneous distribution of the drug is by using rapid bolus instillation in combination with appropriate alveolar recruitment techniques.
KEYWORDS: Neonatology; Preterm infant; Respiratory distress syndrome; Review; Surfactant administration; Ventilation

Disponível em: < https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4456838/ >