{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T13:37:34Z","timestamp":1771335454383,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:00:00Z","timestamp":1752537600000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To compare effects of bolus and aerosolization surfactant delivery methods and ventilatory support on improving ex\u2010vivo premature sheep lung function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The xPULM lung simulator was used with 16 ex\u2010vivo preterm sheep lungs, of which 6 were analyzed in the bolus group and 3 in the aerosol group after excluding 7 lungs that ruptured during the trial. Surfactant (0.5\u2009mL poractant alfa) was administered via bolus injection or aerosolization. Tidal volume (VT) was measured before and after administration at positive end\u2010expiratory pressure (PEEP) levels of 0, 5, 10, and 15\u2009cmH\u2082O.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Surfactant administration significantly increased VT (presurfactant median VT\u2009=\u20090.21\u2009mL; post\u2010surfactant median VT\u2009=\u20091.03\u2009mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). There was a trend toward higher median VT with bolus delivery (1.48\u2009mL) compared to aerosolized delivery (0.43\u2009mL) with borderline significance (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.047) between the two delivery methods. High PEEP levels before surfactant delivery caused lung overdistention. Histological analysis revealed minimal lung tissue injury across samples, despite experimental challenges.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In ex\u2010vivo preterm sheep lungs, surfactant delivery is the primary driver of improved lung function, while PEEP has a smaller impact. The xPULM lung simulator enables research during spontaneous breathing while avoiding ethical issues associated with animal models.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71205","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T11:11:16Z","timestamp":1752577876000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surfactant Delivery Is Crucial for Enhancing Function of Ex\u2010Vivo Premature Sheep Lungs: A Feasibility Study"],"prefix":"10.1002","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7245-5117","authenticated-orcid":false,"given":"Richard","family":"Pasteka","sequence":"first","affiliation":[{"name":"Department Life Science Engineering, Competence Centre Medical Engineering &amp; Integrated Healthcare University of Applied Sciences Technikum Wien Vienna 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