Laryngeal mask airway for surfactant administration in a newborn animal model.

Premature infants are subjected to adverse effects of intubation to benefit from surfactant. We hypothesized that administration of surfactant through a laryngeal mask airway (LMA) is as effective as administration through an endotracheal tube (ETT) and that time and physiologic changes during instrumentation will be less in the LMA group. This study is a randomized, controlled trial using newborn pigs.

Improved gas exchange and survival after KL-4 surfactant in newborn pigs with severe acute lung injury.

Objective: To determine the effectiveness of artificial surfactant therapy using KL-4 surfactant in newborn pigs with hydrochloric acid (HCl)-induced acute lung injury (ALI).

Design: After induction of ALI via intratracheal HCl instillation, pigs were randomized to receive 5.8 ml/kg KL-4 surfactant or no surfactant prior to extubation to bubble CPAP.

Observational study of humidified high-flow nasal cannula compared with nasal continuous positive airway pressure.

Objectives: To conduct an in vitro evaluation of a humidified high-flow nasal cannula (HFNC) system at different flows, cannula sizes, and air leaks and also an in vivo analysis of mean end-expiratory esophageal pressure (EEEP) from nasal continuous positive airway pressure at 6 cm H(2)O (NCPAP+6) versus HFNC.

Study Design: In the in vitro study, we measured HFNC system pressure and flow, with varying degrees of leak and with and without the use of a pressure-limiting valve. In the in vivo study, we measured EEEP in 15 newborns on NCPAP+6 and then on HFNC at 6 L/minute, with flow decreased by 1 L/minute every 30 minutes.

Gas exchange and lung inflammation using nasal intermittent positive-pressure ventilation versus synchronized intermittent mandatory ventilation in piglets with saline lavage-induced lung injury: an observational study.

Objective: Physiologic and pathologic comparison of two modes of assisted ventilation, nasal intermittent positive-pressure ventilation (NIPPV) and synchronized intermittent mandatory ventilation (SIMV), in spontaneously breathing term newborn piglets with saline lavage-induced lung injury.

Design: After inducing acute lung injury via repetitive saline lavage, piglets were randomized to NIPPV (n = 12) or SIMV (n = 11) and treated for 6 hrs.

Setting: Clinical laboratory.

Clinical validation of a continuous intravascular neonatal blood gas sensor introduced through an umbilical artery catheter.

Introduction: Arterial blood gas (ABG) values are a necessary diagnostic measurement in the management of critically ill neonates. We hypothesized that a fiberoptic intravascular blood gas sensor, adapted for use through an umbilical artery catheter, would produce blood gas results with clinically acceptable bias and precision, in comparison to laboratory values, but with no blood loss.

Methods: We evaluated a fiberoptic intravascular blood gas sensor (Neotrend) in 23 consecutive neonates suffering respiratory failure.