China
Africa
Explore chapters and articles related to this topic
Medicines in neonates
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
New synthetic surfactant preparations are being developed to replace the current animal-derived or natural surfactants. These include KL4 (Surfaxin), recombinant SP-C (Venticute) and analogues of SP-B and SP-C [48,49]. Studies in animals have been undertaken and some clinical trials have been planned or are in progress. These surfactants may be more resistant to inactivation by proteins which have leaked into the airways and thus may have an important place in treatment of ARDS where there is secondary surfactant deficiency. However, as they are likely to be easier to produce than existing surfactants, they may also have a role in treatment of RDS.
Paper 3
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
The child has features of pulmonary interstitial emphysema (PIE). This typically develops in premature infants with severe surfactant deficiency causing respiratory distress syndrome. Surfactant deficiency is associated with reduced lung volumes. Artificial ventilation can cause air to track into the interstitial space causing pneumothoraces. Air can also track centrally and cause pneumomediastinum. The appearance of the thymus in this case is consistent with pneumomediastinum, with surrounding air and displacement of the thymic lobes laterally. Both pneumothorax and pneumomediastinum are important complications to recognise and inform the clinical team about promptly.
The patient with acute respiratory problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
Alveoli are supplied with a vast network of pulmonary capillaries, with each alveolus having a single capillary so that alveolar air and pulmonary capillary blood is in close contact. The alveolar wall is extremely thin, and is made up of pneumocyte cells and macrophage cells. Type I pneumocytes are flat squamous cells, whilst type II are larger cells that release surfactant. The alveolar lining consists of an interface of water and gas molecules, which increases the surface tension of each alveolus, creating instability and potential alveolar collapse. Surfactant is a detergent-like substance that reduces this surface tension, thereby increasing compliance and reducing the work of breathing.
The COVID-19 pandemic: a target for surfactant therapy?
Published in Expert Review of Respiratory Medicine, 2021
Ruud A.W. Veldhuizen, Yi Y. Zuo, Nils O. Petersen, James F. Lewis, Fred Possmayer
The current review will explore the above considerations as they relate to the potential of exogenous surfactant therapy for COVID-19 patients. This approach represents a supportive therapy aimed at mitigating the progression of lung injury in patients with lung dysfunction due to COVID-19. As of the writing of this review there are five clinical trials of surfactant therapy for COVID-19 patients registered (Table 1) [1–5] and an initial report has been published on the utilization of this therapy in five individual patients [6]. We will provide an overview of surfactant function as well as both the success and failures of exogenous surfactant therapy in neonatal and adult respiratory distress syndrome. Subsequently, we will discuss five guiding postulates deemed important for the design and interpretation of clinical studies on exogenous surfactant therapy for COVID-19.
The role of vitamin E acetate (VEA) and its derivatives in the vaping associated lung injury: systematic review of evidence
Published in Critical Reviews in Toxicology, 2021
Gabor Xantus, Valeria Anna Gyarmathy, Carole Ann Johnson, Pavanjit Sanghera, Laszlo Zavori, Peter Laszlo Kanizsai
Surfactants play an essential role in the physiology of gas exchange in a healthy lung, and abnormalities in its production or composition are often linked to common lung pathologies, such as acute respiratory distress syndrome (ARDS). The primary role of surfactant in the lung is to prevent atelectasis at the end of expiration by reducing the surface tension between the air- and water layer of the alveoli. Surface tension is essentially the result of forces between water molecules acting in the plane of the surface (The Editors of Encyclopaedia Britannica 2020). The alveoli are less likely to collapse in the presence of an adequate amount and quality of surfactant, as according to Laplace’s law (Valentinuzzi and Kohen 2011) reducing surface tension also lowers the collapsing pressure of the alveoli.
New perpective for an old problem: extracellular vesicle based management of respiratory distress syndrome
Published in Drug Delivery, 2021
Exogenous surfactant treatment is one of the game changing advancements in neonatology that creates a major improvement in morbidity and mortality of preterm infants with respiratory distress syndrome (RDS). Administration of exogenous surfactant has been recognized as the standard therapeutic procedure for more than three decades. Both synthetic and animal-derived exogenous surfactant preparations are shown to be succesful in the prevention and treatment of RDS. Although it is well established strategy in the clinical practice, numerous studies focusing on the dose, formulation and mode of administration continiue over a dozen of years. Ongoing studies mainly address the increasing clinical demand for improvement in pulmonary distribution with better pool size, along with new techniques of delivery (Niemarkt et al., 2017).