Recommendations for respiratory support in the newborn (III). Surfactant and nitric oxide

Salinas, Félix Castillo; Laso, A. Gutiérrez; Hernando, J. Moreno; Lozano, G. Bustos; Muñoz, Manuel Gresa; Goya, J. López de Heredia; Carrascosa, M. Aguar; Echegoyen, Xavier Miracle; Lorenzo, José Ramón Fernández; Serrano, Mayrelly Manzano; Guisán, Ana Concheiro; Carrasco, Cristián; Gómez, Juan José Comuñas; Pumarega, María Teresa Moral; Torres, A.; Franco, M.L.

doi:10.1016/j.anpede.2015.09.014

Cited by 1 publication

(1 citation statement)

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“…On the other side, there is growing evidence of surfactant lavage benefit in both experimental and clinical MAS (Lista et al 2006, Dargaville 2012a, Lin et al 2014 with some authors finding the combination of surfactant lavage and bolus the most effective treatment (Henn et al 2015). This resulted in the fact, that some current national guidelines recommend therapeutic use of exogenous surfactant in severe MAS (Castillo Salinas et al 2015, Chettri et al 2016.…”

Section: Discussionmentioning

confidence: 99%

Selective Inhibition of NF-κB and Surfactant Therapy in Experimental Meconium-Induced Lung Injury

Kopincova

Mikolka²,

M³

et al. 2017

Physiol Res

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Meconium aspiration syndrome (MAS) in newborns is characterized mainly by respiratory failure due to surfactant dysfunction and inflammation. Previous meta-analyses did not prove any effect of exogenous surfactant treatment nor glucocorticoid administration on final outcome of children with MAS despite oxygenation improvement. As we supposed there is the need to intervene in both these fields simultaneously, we evaluated therapeutic effect of combination of exogenous surfactant and selective inhibitor of NF-κB (IKK-NBD peptide). Young New Zealand rabbits were instilled by meconium suspension and treated by surfactant alone or surfactant in combination with IKK-NBD, and oxygen-ventilated for 5 h. PaO2/FiO2, oxygenation index, oxygen saturation and ventilation efficiency index were evaluated every hour; post mortem, total and differential leukocyte counts were investigated in bronchoalveolar lavage fluid (BALF) and inflammatory, oxidative and apoptotic markers were assessed in lung tissue homogenates. Exogenous surfactant combined with IKK-NBD improved oxygenation, reduced neutrophil count in BALF and levels of IL-1β, IL-6, p38 MAPK and caspase 3 in comparison with surfactant-only therapy. It seems that inhibition of inflammation may be strong supporting factor in surfactant treatment of MAS.

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Section: Discussionmentioning

confidence: 99%