{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T21:28:09Z","timestamp":1771363689250,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,12,27]],"date-time":"2023-12-27T00:00:00Z","timestamp":1703635200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100008873","name":"European Society for Paediatric Research","doi-asserted-by":"publisher","award":["RGP2022\u2010EPDRG\u201001\/04"],"award-info":[{"award-number":["RGP2022\u2010EPDRG\u201001\/04"]}],"id":[{"id":"10.13039\/501100008873","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Respiratory distress syndrome often necessitates endotracheal surfactant administration in extremely preterm infants. Our study aimed to explore a multi\u2010modal simulation tool for investigating treatment strategies in ex\u00a0vivo sheep lungs during spontaneous breathing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An electromechanical lung simulator (xPULM) mimicking spontaneous breathing was coupled with a non\u2010aerated premature sheep lung, replicating a premature respiratory system. Changes in tidal volume for different positive end\u2010expiratory pressure (PEEP) levels prior to and after either bolus or nebulised surfactant administration were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In two preterm sheep lungs, we observed a progressive decline in tidal volume with increasing PEEP levels prior to surfactant delivery from 0.30\u2009\u00b1\u20090.01\u2009mL at zero PEEP to 0.04\u2009\u00b1\u20090.01\u2009mL at 15 cmH2O PEEP. Our measurements showed that both bolus (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) and nebulised (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) surfactant administration resulted in a significant increase in tidal volume, with no significant difference (<jats:italic>p<\/jats:italic>\u2009=\u20090.71) between the two methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The experimental setup demonstrated the feasibility of xPULM for investigating the effectiveness of different PEEP levels and modes of surfactant administration with respect to tidal volume in premature sheep lungs. The lack of adequate lung water resorption in our model warrants further investigations.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.17083","type":"journal-article","created":{"date-parts":[[2023,12,27]],"date-time":"2023-12-27T10:04:10Z","timestamp":1703671450000},"page":"722-730","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Positive end\u2010expiratory pressure and surfactant administration mode influence function in ex\u2010vivo premature sheep lungs"],"prefix":"10.1111","volume":"113","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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