Aerosolized lucinactant: a potential alternative to intratracheal surfactant replacement therapy

Abstract

Background: Surfactant replacement therapy (SRT) has been demonstrated to be both safe and highly effective in the treatment of preterm infants with respiratory distress syndrome (RDS). However, administration of the various available suspensions has required endotracheal intubation and its inherent risks. Delivery of aerosolized SRT would be a laudable goal. Objective: To review the chemistry, pharmacodynamics, clinical efficacy and safety of aerosolized lucinactant for the prevention/treatment of RDS in the preterm infant. Methods: Laboratory and clinical experience with aerosolized lucinactant are reviewed. Results/conclusions: Laboratory studies confirm the ability of lucinactant to withstand the aerosolization process and to maintain its biological activity. A small clinical pilot trial demonstrated safety and feasibility and provided a signal to suggest proof of concept and the justification for a larger Phase III trial.

Keywords::

• continuous positive airway pressure
• lucinactant
• prematurity
• respiratory distress syndrome
• surfactant