Pediatrics & Neonatology
Volume 51, Issue 4 , Pages 219-226 , August 2010

Acute Pathophysiological Effects of Intratracheal Instillation of Budesonide and Exogenous Surfactant in a Neonatal Surfactant-depleted Piglet Model

  • Chia-Feng Yang

      Affiliations

    • Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan
    • Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
    • Department of Pediatrics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
    • ,
  • Mei-Jy Jeng

      Affiliations

    • Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan
    • Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
    • Department of Pediatrics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
    • Corresponding Author InformationCorresponding author. Department of Pediatrics, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 11217, Taiwan
    • ,
  • Wen-Jue Soong

      Affiliations

    • Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan
    • Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
    • Department of Pediatrics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
    • ,
  • Yu-Sheng Lee

      Affiliations

    • Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan
    • Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
    • Department of Pediatrics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
    • ,
  • Pen-Chen Tsao

      Affiliations

    • Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan
    • Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
    • Department of Pediatrics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
    • ,
  • Ren-Bin Tang

      Affiliations

    • Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan

Received 12 October 2009 ,Revised 28 October 2009 ,Accepted 16 November 2009.

References 

  1. Cools F , Henderson-Smart DJ , Offringa M , Askie LM . Elective high-frequency oscillatory ventilation versus conventional ventilation for acute pulmonary dysfunction in preterm infants . Cochrane Database Syst Rev . 2009;3: CD000104.
  2. Engle WA , American Academy of Pediatrics Committee on Fetus and Newborn  . Surfactant-replacement therapy for respiratory distress in the preterm and term neonate . Pediatrics . 2008;121:419–432
  3. Crowley P . WITHDRAWN: Prophylactic corticosteroids for preterm birth . Cochrane Database Syst Rev . 2007;3: CD000065.
  4. Shah V , Ohlsson A , Halliday HL , Dunn MS . Early administration of inhaled corticosteroids for preventing chronic lung disease in ventilated very low birth weight preterm neonates . Cochrane Database Syst Rev . 2007;4: CD001969.
  5. Sweet D , Bevilacqua G , Carnielli V , et al.   European consensus guidelines on the management of neonatal respiratory distress syndrome . J Perinat Med . 2007;35:175–186
  6. Stevens TP , Blennow M , Myers EH , Soll R . Early surfactant administration with brief ventilation vs. selective surfactant and continued mechanical ventilation for preterm infants with or at risk for respiratory distress syndrome . Cochrane Database Syst Rev . 2007;4: CD003063.
  7. Crowther CA , Harding JE . Repeat doses of prenatal corticosteroids for women at risk of preterm birth for preventing neonatal respiratory disease . Cochrane Database Syst Rev . 2007;3: CD003935.
  8. Teksam O , Kale G . The effects of surfactant and antenatal corticosteroid treatment on the pulmonary pathology of preterm infants with respiratory distress syndrome . Pathol Res Pract . 2009;205:35–41
  9. Yeh TF , Lin HC , Chang CH , et al.   Early intratracheal instillation of budesonide using surfactant as a vehicle to prevent chronic lung disease in preterm infants: a pilot study . Pediatrics . 2008;121:e1310–e1318
  10. Collaborative Dexamethasone Trial Group . Dexamethasone therapy in neonatal chronic lung disease: an international placebo-controlled trial . Pediatrics . 1991;88:421–427
  11. Yeh TF , Torre JA , Rastogi A , Anyebuno MA , Pildes RS . Early postnatal dexamethasone therapy in premature infants with severe respiratory distress syndrome: a double-blind, controlled study . J Pediatr . 1990;117:273–282
  12. Halliday HL , Ehrenkranz RA . Early postnatal (< 96 hours) corticosteroids for preventing chronic lung disease in pre-term infants . Cochrane Database Syst Rev . 2000;2: CD001146.
  13. Vermont Oxford Network Steroid Study Group  . Early postnatal dexamethasone therapy for the prevention of chronic lung disease . Pediatrics . 2001;1083:741–748
  14. Buimer M , van Wassenaer AG , Kok JH . Postnatal administration of dexamethasone for weaning off the ventilator affects thyroid function . Neonatology . 2008;94:164–169
  15. Shah SS , Ohlsson A , Halliday H , Shah VS . Inhaled versus systemic corticosteroids for the treatment of chronic lung disease in ventilated very-low-birth-weight preterm infants . Cochrane Database Syst Rev . 2007;4: CD002057.
  16. Yeh TF , Lin YJ , Huang CC , et al.   Early dexamethasone therapy in preterm infants: a follow-up study . Pediatrics . 1998;101:E7
  17. Gross SJ , Anbar RD , Mettelman BB . Follow-up at 15 years of preterm infants from a controlled trial of moderately early dexamethasone for the prevention of chronic lung disease . Pediatrics . 2005;115:681–687
  18. Shinwell ES , Karplus M , Reich D , et al.   Early postnatal dexamethasone treatment and increased incidence of cerebral palsy . Arch Dis Child Fetal Neonatal Ed . 2000;83:F177–F181
  19. Jeng MJ , Soong WJ , Lee YS . Effective lavage volume of diluted surfactant improves the outcome of meconium aspiration syndrome in newborn piglets . Pediatr Res . 2009;66:107–112
  20. Jeng MJ , Lee YS , Soong WJ . Effects of perfluorochemicals for intrapulmonary vancomycin administration and partial liquid ventilation in an animal model of meconium-injured lungs . Acta Paediatr Taiwan . 2007;48:309–316
  21. Jeng MJ , Soong WJ , Lee YS , et al.   Effects of therapeutic broncho-alveolar lavage and partial liquid ventilation on meconium-aspirated newborn piglets . Critical Care Medicine . 2006;34:1099–1105
  22. Lachmann B , Roberston B , Petro W , et al.   Experimental respiratory distress induced by removal of alveolar surfactant with bronchial lavage . Bull Eur Physiopath Respir . 1976;12:186–187
  23. Jeng MJ , Kou YR , Sheu CC , Hwang B . Effects of partial liquid ventilation with FC-77 on acute lung injury in newborn piglets . Pediatr Pulmonol . 2002;33:12–21
  24. Jeng MJ , Yang SS , Wolfson MR , Shaffer TH . Perfluorochemical (PFC) combinations for acute lung injury: an in vitro and in vivo study in juvenile rabbits . Pediatr Res . 2003;53:81–88
  25. Rotta AT , Steinhorn DM . Partial liquid ventilation reduces pulmonary neutrophil accumulation in an experimental model of systemic endotoxemia and acute lung injury . Crit Care Med . 1998;26:1707–1715
  26. Jeng MJ , Kou YR , Sheu CC , Hwang B . Effects of exogenous surfactant supplementation and partial liquid ventilation on acute lung injury induced by wood smoke inhalation in newborn piglets . Crit Care Med . 2003;31:1166–1174
  27. Halliday HL , Ehrenkranz RA , Doyle LW . Moderately early (7-14 days) postnatal corticosteroids for preventing chronic lung disease in preterm infants . Cochrane Database Syst Rev . 2003;1: CD001144.
  28. Halliday HL , Ehrenkranz RA , Doyle LW . Late (> 7 days) postnatal corticosteroids for chronic lung disease in preterm infants . Cochrane Database Syst Rev . 2009;1: CD001145.
  29. Halliday HL , Ehrenkranz RA , Doyle LW . Early (< 8 days) postnatal corticosteroids for preventing chronic lung disease in preterm infants . Cochrane Database Syst Rev . 2009;1: CD001146.
  30. Romagnoli C , Zecca E , Luciano R , Torrioli G , Tortorolo G . A three year follow-up of preterm infants after moderately early treatment with dexamethasone . Arch Dis Child Fetal Neonatal Ed . 2002;87:F55–F58
  31. O'Callaghan C , Hardy J , Stammers J , Stephenson TJ , Hull D . Evaluation of techniques for delivery of steroids to lungs of neonates using a rabbit model . Arch Dis Child . 1992;67:20–24
  32. Fajardo C , Levin D , Garcia M , Adrams D , Adamson I . Surfactant versus saline as a vehicle for corticosteroid delivery to the lungs of ventilated rabbits . Pediatr Res . 1998;43:542–547
  33. Chen CM , Fang CL , Chang CH . Surfactant and corticosteroid effects on lung function in a rat model of acute lung injury . Crit Care Med . 2001;29:2169–2175
  34. Cullen AB , Cox CA , Hipp SJ , Wolfson MR , Shaffer TH . Intra-tracheal delivery strategy of gentamicin with partial liquid ventilation . Respir Med . 1999;93:770–778
  35. Mokra D , Mokry J , Drgova A , Petraskova M , Bulikova J , Calkovska A . Intratracheally administered corticosteroids improve lung function in meconium-instilled rabbits . J Physiol Pharmacol . 2007;58:389–398
  36. Hvizdos KM , Jarvis B . Budesonide inhalation suspension: a review of its use in infants, children and adults with inflammatory respiratory disorders . Drugs . 2000;60:1141–1178
  37. Szefler SJ . Pharmacodynamics and pharmacokinetics of budesonide: a new nebulized corticosteroid . J Allergy Clin Immunol . 1999;104:175–183
  38. Arnon S . Grigg J, Nikander K, Silverman M. Delivery of micronized budesonide suspension by metered dose inhaler and jet nebulizer into a neonatal ventilator circuit . Pediatr Pulmonol . 1992;13:172–175
  39. Plam S , Wiedmann TS . Note: dissolution of aerosol particles of budesonide in Survanta TM, a model lung surfactant . J Pharmaceutical Sci . 2001;90:98–104
  40. Kharasch VS , Sweeney TD , Fredberg J , et al.   Pulmonary surfactant as a vehicle for intratracheal delivery of technetium sulfur colloid and pentamidine in hamster lungs . Am Rev Respir Dis . 1991;144:909–913
  41. Yu ZW , Zhang JH . Effect of inhaled budesonide on surfactant protein expression in asthmatic mice . Allergy Asthma Proc . 2008;29:486–492
  42. Bouwman AM , Heijstra MP , Schaefer NC , Duiverman EJ , Lesouëf PN , Devadason SG . Improved efficiency of budesonide nebulization using surface-active agents . Drug Deliv . 2006;13:357–363
  43. Chen CM , Wang LF , Su B , Hsu HH . Methylprednisolone effects on oxygenation and histology in a rat model of acute lung injury . Pulm Pharmacol Ther . 2003;16:215–220
  44. Chen CM , Su B , Hsu CC , Wang LF . Methylprednisolone does not enhance the surfactant effects on oxygenation and histology in paraquat-induced rat lung injury . Intensive Care Med . 2002;28:1138–1144

PII: S1875-9572(10)60042-3

doi: 10.1016/S1875-9572(10)60042-3

Pediatrics & Neonatology
Volume 51, Issue 4 , Pages 219-226 , August 2010

Article Tools