{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T06:33:05Z","timestamp":1789194785869,"version":"build-2803163510"},"reference-count":98,"publisher":"ASME International","issue":"10","license":[{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.asme.org\/publications-submissions\/publishing-information\/legal-policies"}],"funder":[{"DOI":"10.13039\/100000001","name":"National Science Foundation","doi-asserted-by":"publisher","award":["1904210"],"award-info":[{"award-number":["1904210"]}],"id":[{"id":"10.13039\/100000001","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["asmedigitalcollection.asme.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Surfactant replacement therapy (SRT) is a widely used treatment for neonatal respiratory distress syndrome (NRDS), a condition caused by surfactant deficiency that leads to alveolar collapse and impaired gas exchange. While SRT has significantly improved clinical outcomes for neonates, challenges remain in achieving uniform and effective surfactant delivery throughout the lung. This review provides an overview of the pulmonary surfactant, lung development, and the underlying causes of NRDS to establish the physiological context of SRT. We then examine key advancements in experimental and computational modeling approaches that have been used to study surfactant transport and optimize delivery techniques. Computational models have provided insight into fundamental aspects of transport of surfactant as liquid boli or aerosols and the influence of airway geometry on surfactant spreading on airway walls and distribution in the airway tree. Benchtop models, including 3D multigeneration airway models and planar microfluidic devices, have enabled experimental control and visualization of surfactant spreading in airways. And studies using animal models have enabled testing different dosing strategies and delivery methods with full lung models, albeit interspecies differences in the lung anatomy make direct translation to humans difficult. Together, research using these models has highlighted the importance of optimizing delivery parameters such as dose volume, instillation flow rate, aerosol particle size, and lung orientation to improve therapeutic outcomes. The integration of these multidisciplinary approaches is critical to advance next-generation SRT strategies that are more efficient, less invasive, and better suited to the unique physiology of preterm infants.<\/jats:p>","DOI":"10.1115\/1.4069657","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T15:34:09Z","timestamp":1756740849000},"update-policy":"https:\/\/doi.org\/10.1115\/crossmarkpolicy-asme","source":"Crossref","is-referenced-by-count":2,"title":["Models of Surfactant Replacement Therapy in Neonatal Lungs"],"prefix":"10.1115","volume":"147","author":[{"given":"Hannah","family":"Combs","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering, The University of Akron , 244 Sumner Street, Akron, OH 44325"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hossein","family":"Tavana","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, The University of Akron , 244 Sumner Street, Akron, OH 44325"},{"id":[{"id":"https:\/\/ror.org\/02kyckx55","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Akron"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"33","published-online":{"date-parts":[[2025,9,12]]},"reference":[{"issue":"1","key":"2025091211295703800_bib1","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1542\/peds.2013-3443","article-title":"Surfactant Replacement Therapy for Preterm and Term Neonates With Respiratory Distress","volume":"133","year":"2014","journal-title":"Pediatrics"},{"issue":"11","key":"2025091211295703800_bib2","first-page":"1242","article-title":"Neonatal Tracheal Intubation in the NICU: A Literature Review","volume":"13","year":"2025","journal-title":"Healthcare (Basel"},{"issue":"4","key":"2025091211295703800_bib3","doi-asserted-by":"crossref","first-page":"e2020035899","DOI":"10.1542\/peds.2020-035899","article-title":"Reducing Severe Tracheal Intubation Events Through an Individualized Airway Bundle","volume":"148","year":"2021","journal-title":"Pediatrics"},{"issue":"6","key":"2025091211295703800_bib4","doi-asserted-by":"crossref","first-page":"493","DOI":"10.3390\/children8060493","article-title":"Aerosolized Surfactant for Preterm Infants With Respiratory Distress Syndrome","volume":"8","year":"2021","journal-title":"Children"},{"key":"2025091211295703800_bib5","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.earlhumdev.2019.05.005","article-title":"Aerosolized Surfactant in Neonatal Respiratory Distress Syndrome: Phase I Study","volume":"134","year":"2019","journal-title":"Early Hum. Dev."},{"issue":"2","key":"2025091211295703800_bib6","first-page":"55","article-title":"Microaerosol Administration of Synthetic Beta-Gamma-Dipalmitoyl-L-Alpha-Lecithin in the Respiratory Distress Syndome: A Preliminary Report","volume":"90","year":"1964","journal-title":"Can. Med. Assoc. J."},{"issue":"5","key":"2025091211295703800_bib7","doi-asserted-by":"crossref","first-page":"e20193967","DOI":"10.1542\/peds.2019-3967","article-title":"Aerosolized Calfactant for Newborns With Respiratory Distress: A Randomized Trial","volume":"146","year":"2020","journal-title":"Pediatrics"},{"issue":"8","key":"2025091211295703800_bib8","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1038\/s41372-023-01722-4","article-title":"Predictors of Successful Treatment of Respiratory Distress With Aerosolized Calfactant","volume":"43","year":"2023","journal-title":"J. Perinatol."},{"issue":"3","key":"2025091211295703800_bib9","doi-asserted-by":"crossref","first-page":"F313","DOI":"10.1136\/archdischild-2018-315051","article-title":"Nebulised Surfactant to Reduce Severity of Respiratory Distress: A Blinded, Parallel, Randomised Controlled Trial","volume":"104","year":"2019","journal-title":"Arch. Dis. Child. - Fetal Neonat. Ed."},{"key":"2025091211295703800_bib10","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.jpeds.2022.02.054","article-title":"A Randomized, Controlled Trial to Investigate the Efficacy of Nebulized Poractant Alfa in Premature Babies With Respiratory Distress Syndrome","volume":"246","year":"2022","journal-title":"J. Pediatr."},{"issue":"1","key":"2025091211295703800_bib11","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1136\/archdischild-2021-321645","article-title":"Trial of Aerosolised Surfactant for Preterm Infants With Respiratory Distress Syndrome","volume":"107","year":"2022","journal-title":"Arch. Dis. Child. - Fetal Neonat. Ed."},{"issue":"8159","key":"2025091211295703800_bib12","first-page":"55","article-title":"Artificial Surfactant Therapy in Hyaline-Membrane Disease","volume":"1","year":"1980","journal-title":"Lancet"},{"issue":"8832","key":"2025091211295703800_bib13","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1016\/0140-6736(92)92557-V","article-title":"Early Versus Delayed Neonatal Administration of a Synthetic Surfactant\u2014The Judgment of OSIRIS","volume":"340","author":"The Osiris Collaborative Group","year":"1992","journal-title":"Lancet"},{"issue":"1","key":"2025091211295703800_bib14","doi-asserted-by":"crossref","first-page":"F8","DOI":"10.1136\/fn.72.1.F8","article-title":"Randomised Clinical Trial of Two Treatment Regimens of Natural Surfactant Preparations in Neonatal Respiratory Distress Syndrome","volume":"72","year":"1995","journal-title":"Arch. Dis. Child. - Fetal Neonat. Ed."},{"issue":"16","key":"2025091211295703800_bib15","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1056\/NEJM199410203311603","article-title":"Surfactant Therapy and Nasal Continuous Positive Airway Pressure for Newborns With Respiratory Distress Syndrome. Danish-Swedish Multicenter Study Group","volume":"331","year":"1994","journal-title":"N. Engl. J. Med."},{"issue":"1","key":"2025091211295703800_bib16","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1186\/s12931-022-02007-8","article-title":"Efficacy, Dose\u2013Response, and Aerosol Delivery of Dry Powder Synthetic Lung Surfactant Treatment in Surfactant-Deficient Rabbits and Premature Lambs","volume":"23","year":"2022","journal-title":"Respir. Res."},{"issue":"3","key":"2025091211295703800_bib17","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1007\/s00441-016-2545-0","article-title":"Development of the Lung","volume":"367","year":"2017","journal-title":"Cell Tissue Res."},{"issue":"3530","key":"2025091211295703800_bib18","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1126\/science.137.3530.577","article-title":"Architecture of the Human Lung","volume":"137","year":"1962","journal-title":"Science"},{"issue":"1","key":"2025091211295703800_bib19","first-page":"12","article-title":"Neonatal Respiratory Distress Syndrome: Tackling a Worldwide Problem","volume":"44","year":"2019","journal-title":"P T"},{"issue":"1","key":"2025091211295703800_bib20","doi-asserted-by":"crossref","first-page":"2338633","DOI":"10.1080\/16549716.2024.2338633","article-title":"The Role of Chest X-Ray in the Diagnosis of Neonatal Respiratory Distress Syndrome: A Systematic Review Concerning Low-Resource Birth Scenarios","volume":"17","year":"2024","journal-title":"Global Health Action"},{"issue":"1","key":"2025091211295703800_bib21","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1002\/ijgo.13195","article-title":"Global Burden of Preterm Birth","volume":"150","year":"2020","journal-title":"Int. J. Gynecol. Obstet."},{"key":"2025091211295703800_bib22","doi-asserted-by":"crossref","first-page":"864911","DOI":"10.3389\/fped.2022.864911","article-title":"Lung Ultrasound for the Diagnosis and Management of Neonatal Respiratory Distress Syndrome: A Minireview","volume":"10","year":"2022","journal-title":"Front. Pediatr."},{"issue":"8","key":"2025091211295703800_bib23","first-page":"13783","article-title":"Efficacy of Surfactant at Different Gestational Ages for Infants With Respiratory Distress Syndrome","volume":"8","year":"2015","journal-title":"Int. J. Clin. Exp. Med."},{"key":"2025091211295703800_bib24","doi-asserted-by":"crossref","first-page":"113437","DOI":"10.1016\/j.jpeds.2023.113437","article-title":"Estimating Preterm Lung Volume: A Comparison of Lung Ultrasound, Chest Radiography, and Oxygenation","volume":"259","year":"2023","journal-title":"J. Pediatr."},{"issue":"4","key":"2025091211295703800_bib25","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1051\/radiopro\/2018033","article-title":"Radiation Exposure of Very-Low-Birth-Weight Infants in Neonatal Intensive Care Units in Korea","volume":"53","year":"2018","journal-title":"Radioprotection"},{"issue":"2","key":"2025091211295703800_bib26","first-page":"37","article-title":"A Comparative Study of Medical Imaging Techniques","volume":"4","year":"2015","journal-title":"Int. J. Inf. Sci. Intell. Syst."},{"issue":"6","key":"2025091211295703800_bib27","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/S1875-9572(10)60061-7","article-title":"Radiation Safety in the Neonatal Intensive Care Unit: Too Little or Too Much Concern?","volume":"51","year":"2010","journal-title":"Pediatr. Neonatol."},{"key":"2025091211295703800_bib28","article-title":"Lung Imaging","volume-title":"StatPearls","year":"2025"},{"issue":"3","key":"2025091211295703800_bib29","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1016\/j.chest.2022.10.039","article-title":"Commonly Missed Findings on Chest Radiographs: Causes and Consequences","volume":"163","year":"2023","journal-title":"Chest"},{"issue":"10","key":"2025091211295703800_bib30","doi-asserted-by":"crossref","first-page":"2382","DOI":"10.3390\/diagnostics12102382","article-title":"Frequency of Missed Findings on Chest Radiographs (CXRs) in an International, Multicenter Study: Application of AI to Reduce Missed Findings","volume":"12","year":"2022","journal-title":"Diagnostics (Basel"},{"issue":"1","key":"2025091211295703800_bib31","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.medin.2021.10.001","article-title":"Lung Ultrasound Protocol Decreases Radiation in Newborn Population Without Side Effects: A Quality Improvement Project","volume":"47","year":"2023","journal-title":"Med. Intensiva (Engl. Ed.)"},{"issue":"13","key":"2025091211295703800_bib32","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.3390\/diagnostics14131413","article-title":"Setting the Standards: Neonatal Lung Ultrasound in Clinical Practice","volume":"14","year":"2024","journal-title":"Diagnostics (Basel)"},{"issue":"5","key":"2025091211295703800_bib33","doi-asserted-by":"crossref","first-page":"417","DOI":"10.4103\/lungindia.lungindia_13_22","article-title":"Lung Ultrasound (LUS) in Pre-Term Neonates With Respiratory Distress: A Prospective Observational Study","volume":"39","year":"2022","journal-title":"Lung India"},{"issue":"5","key":"2025091211295703800_bib34","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1080\/14767058.2021.1940943","article-title":"Specification and Guideline for Technical Aspects and Scanning Parameter Settings of Neonatal Lung Ultrasound Examination","volume":"35","year":"2022","journal-title":"J. Matern.-Fetal Neonat. Med."},{"issue":"145","key":"2025091211295703800_bib35","first-page":"e58990","article-title":"Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus","year":"2019","journal-title":"JoVE"},{"issue":"7","key":"2025091211295703800_bib36","doi-asserted-by":"crossref","first-page":"595","DOI":"10.21037\/atm-20-2045","article-title":"Measurements of Deposited Aerosol Dose in Infants and Small Children","volume":"9","year":"2021","journal-title":"Ann. Transl. Med."},{"issue":"6","key":"2025091211295703800_bib37","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1046\/j.1365-2125.2000.00215.x","article-title":"Methods to Determine Lung Distribution of Inhaled Drugs\u2014Could Gamma Scintigraphy Be the Gold Standard?","volume":"49","year":"2000","journal-title":"Br. J. Clin. Pharmacol."},{"issue":"Suppl. 1","key":"2025091211295703800_bib38","first-page":"S36","article-title":"Efficacy and Safety of Surfactant Replacement Therapy for Preterm Neonates With Respiratory Distress Syndrome in Low- and Middle-Income Countries: A Systematic Review","volume":"36","year":"2016","journal-title":"J. Perinatol."},{"key":"2025091211295703800_bib39","volume-title":"Ganong's Review of Medical Physiology","year":"2009","edition":"23rd ed."},{"issue":"2","key":"2025091211295703800_bib40","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1002\/ar.1091770207","article-title":"Casting the Lungs In-Situ","volume":"177","year":"1973","journal-title":"Anat. Rec."},{"key":"2025091211295703800_bib41","volume-title":"West's Respiratory Physiology","year":"2020"},{"key":"2025091211295703800_bib42","first-page":"19","article-title":"The Human Respiratory System","year":"2013"},{"issue":"2","key":"2025091211295703800_bib43","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.ymgme.2009.01.015","article-title":"An Overview of Pulmonary Surfactant in the Neonate: Genetics, Metabolism, and the Role of Surfactant in Health and Disease","volume":"97","year":"2009","journal-title":"Mol. Genet. Metab."},{"key":"2025091211295703800_bib44","unstructured":"Physiopedia Contributor, 2024, \u201cLung Anatomy,\u201d Physiopedia, London, UK, accessed Sept. 4, 2025, https:\/\/www.physio-pedia.com\/index.php?title=Lung_Anatomy&oldid=361611"},{"key":"2025091211295703800_bib45","article-title":"Computational Fluid and Particle Dynamics (CFPD): An Introduction","volume-title":"Computational Fluid and Particle Dynamics in the Human Respiratory System","year":"2012"},{"key":"2025091211295703800_bib46","article-title":"Physiology, Pulmonary Ventilation and Perfusion","volume-title":"StatPearls","year":"2025"},{"issue":"Suppl. 2","key":"2025091211295703800_bib47","first-page":"203","article-title":"Pathophysiology of Respiratory Failure and Physiology of Gas Exchange During ECMO","volume":"37","year":"2021","journal-title":"Indian J. Thorac. Cardiovasc. Surg."},{"issue":"5","key":"2025091211295703800_bib48","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1152\/japplphysiol.01291.2012","article-title":"Airway Exchange of Highly Soluble Gases","volume":"114","year":"2013","journal-title":"J. Appl. Physiol."},{"issue":"1","key":"2025091211295703800_bib49","doi-asserted-by":"crossref","first-page":"L130","DOI":"10.1152\/ajplung.00366.2002","article-title":"Thickness of the Blood-Gas Barrier in Premature and 1-Day-Old Newborn Rabbit Lungs","volume":"285","year":"2003","journal-title":"Am. J. Physiol.-Lung Cell. Mol. Physiol."},{"issue":"4","key":"2025091211295703800_bib50","doi-asserted-by":"crossref","first-page":"338","DOI":"10.25122\/jml-2025-0045","article-title":"The Impact of External Environment on Pulmonary Development\u2014A Morphological Evaluation of Pulmonary Tissue in Preterm Infants","volume":"18","year":"2025","journal-title":"J. Med. Life"},{"issue":"48","key":"2025091211295703800_bib51","doi-asserted-by":"crossref","first-page":"18886","DOI":"10.1073\/pnas.0610868104","article-title":"Acoustically Detectable Cellular-Level Lung Injury Induced by Fluid Mechanical Stresses in Microfluidic Airway Systems","volume":"104","year":"2007","journal-title":"Proc. Natl. Acad. Sci."},{"issue":"4","key":"2025091211295703800_bib52","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1039\/C0LC00251H","article-title":"Combination of Fluid and Solid Mechanical Stresses Contribute to Cell Death and Detachment in a Microfluidic Alveolar Model","volume":"11","year":"2011","journal-title":"Lab Chip"},{"issue":"5","key":"2025091211295703800_bib53","first-page":"1302","article-title":"A Lung-on-Chip Array With an Integrated Bio-Inspired Respiration Mechanism","volume":"15","year":"2014","journal-title":"Lab Chip"},{"issue":"1","key":"2025091211295703800_bib54","doi-asserted-by":"crossref","first-page":"6506","DOI":"10.1038\/s41467-023-42171-z","article-title":"A Human Lung Alveolus-on-a-Chip Model of Acute Radiation-Induced Lung Injury","volume":"14","year":"2023","journal-title":"Nat. Commun."},{"issue":"1","key":"2025091211295703800_bib55","doi-asserted-by":"crossref","first-page":"e10715","DOI":"10.1002\/btm2.10715","article-title":"A Stretchable Human Lung-on-Chip Model of Alveolar Inflammation for Evaluating Anti-Inflammatory Drug Response","volume":"10","year":"2025","journal-title":"Bioeng. Transl. Med."},{"issue":"5986","key":"2025091211295703800_bib56","doi-asserted-by":"crossref","first-page":"1662","DOI":"10.1126\/science.1188302","article-title":"Reconstituting Organ-Level Lung Functions on a Chip","volume":"328","year":"2010","journal-title":"Science"},{"issue":"1","key":"2025091211295703800_bib57","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1038\/s42003-021-01695-0","article-title":"Second-Generation Lung-on-a-Chip With an Array of Stretchable Alveoli Made With a Biological Membrane","volume":"4","year":"2021","journal-title":"Commun. Biol."},{"issue":"5","key":"2025091211295703800_bib58","doi-asserted-by":"crossref","first-page":"3744","DOI":"10.1021\/la903038a","article-title":"Dynamics of Liquid Plugs of Buffer and Surfactant Solutions in a Micro-Engineered Pulmonary Airway Model","volume":"26","year":"2010","journal-title":"Langmuir"},{"issue":"4","key":"2025091211295703800_bib59","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1309\/LMJWE0WO65VFWPAS","article-title":"Microfluidics, Lung Surfactant, and Respiratory Disorders","volume":"40","year":"2009","journal-title":"Lab. Med."},{"issue":"4","key":"2025091211295703800_bib60","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1007\/s10544-011-9543-5","article-title":"Epithelium Damage and Protection During Reopening of Occluded Airways in a Physiologic Microfluidic Pulmonary Airway Model","volume":"13","year":"2011","journal-title":"Biomed. Microdevices"},{"key":"2025091211295703800_bib61","article-title":"Histology, Alveolar Cells","volume-title":"StatPearls","year":"2025"},{"issue":"5","key":"2025091211295703800_bib62","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1513\/AnnalsATS.201411-507FR","article-title":"The Role of Surfactant in Lung Disease and Host Defense Against Pulmonary Infections","volume":"12","year":"2015","journal-title":"Ann. Am. Thorac. Soc."},{"issue":"8","key":"2025091211295703800_bib63","doi-asserted-by":"crossref","first-page":"2317","DOI":"10.1016\/j.micinf.2006.04.009","article-title":"Surfactant Protein C: Its Unique Properties and Emerging Immunomodulatory Role in the Lung","volume":"8","year":"2006","journal-title":"Microbes Infect."},{"issue":"3","key":"2025091211295703800_bib64","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.resp.2006.06.009","article-title":"Effect of Humidity on Lung Surfactant Films Subjected to Dynamic Compression\/Expansion Cycles","volume":"155","year":"2007","journal-title":"Respir. Physiol. Neurobiol."},{"key":"2025091211295703800_bib65","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.cobme.2019.11.003","article-title":"Multiscale In Silico Lung Modeling Strategies for Aerosol Inhalation Therapy and Drug Delivery","volume":"11","year":"2019","journal-title":"Curr. Opin. Biomed. Eng."},{"issue":"3","key":"2025091211295703800_bib66","first-page":"91","article-title":"Surfactant Administration in Neonates: A Review of Delivery Methods","volume":"50","year":"2014","journal-title":"Can. J. Respir. Ther."},{"issue":"5","key":"2025091211295703800_bib67","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1115\/1.1798051","article-title":"Steady Propagation of a Liquid Plug in a Two-Dimensional Channel","volume":"126","year":"2004","journal-title":"ASME J. Biomech. Eng."},{"key":"2025091211295703800_bib68","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1017\/jfm.2019.333","article-title":"Effects of Surfactant on Propagation and Rupture of a Liquid Plug in a Tube","volume":"872","year":"2019","journal-title":"J. Fluid Mech."},{"issue":"8","key":"2025091211295703800_bib69","doi-asserted-by":"crossref","first-page":"082102","DOI":"10.1063\/1.1948907","article-title":"The Steady Propagation of a Surfactant-Laden Liquid Plug in a Two-Dimensional Channel","volume":"17","year":"2005","journal-title":"Phys. Fluids"},{"issue":"6","key":"2025091211295703800_bib70","doi-asserted-by":"crossref","first-page":"62104","DOI":"10.1063\/1.2938381","article-title":"Unsteady Propagation of a Liquid Plug in a Liquid-Lined Straight Tube","volume":"20","year":"2008","journal-title":"Phys. Fluids (1994)"},{"issue":"2","key":"2025091211295703800_bib71","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1152\/japplphysiol.00796.2004","article-title":"Epithelial Cell Deformation During Surfactant-Mediated Airway Reopening: A Theoretical Model","volume":"99","year":"2005","journal-title":"J. Appl. Physiol. (1985)"},{"issue":"4","key":"2025091211295703800_bib72","doi-asserted-by":"crossref","first-page":"2238","DOI":"10.1016\/j.jcp.2007.10.003","article-title":"A Front-Tracking Method for Computation of Interfacial Flows With Soluble Surfactants","volume":"227","year":"2008","journal-title":"J. Comput. Phys."},{"issue":"5","key":"2025091211295703800_bib73","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1089\/jamp.2013.1077","article-title":"Optimal Delivery of Aerosols to Infants During Mechanical Ventilation","volume":"27","year":"2014","journal-title":"J. Aerosol Med. Pulm. Drug Delivery"},{"issue":"12","key":"2025091211295703800_bib74","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1080\/17425247.2018.1544616","article-title":"Models of Deposition, Pharmacokinetics, and Intersubject Variability in Respiratory Drug Delivery","volume":"15","year":"2018","journal-title":"Expert Opin. Drug Delivery"},{"issue":"1","key":"2025091211295703800_bib75","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1080\/17425247.2019.1551875","article-title":"Use of Computational Fluid Dynamics Deposition Modeling in Respiratory Drug Delivery","volume":"16","year":"2019","journal-title":"Expert Opin. Drug Delivery"},{"issue":"5","key":"2025091211295703800_bib76","doi-asserted-by":"crossref","first-page":"726","DOI":"10.3390\/atmos13050726","article-title":"CFD Study of Dry Pulmonary Surfactant Aerosols Deposition in Upper 17 Generations of Human Respiratory Tract","volume":"13","year":"2022","journal-title":"Atmosphere"},{"issue":"7","key":"2025091211295703800_bib77","doi-asserted-by":"crossref","first-page":"071901","DOI":"10.1063\/1.4812589","article-title":"Computational Modeling of Unsteady Surfactant-Laden Liquid Plug Propagation in Neonatal Airways","volume":"25","year":"2013","journal-title":"Phys. Fluids"},{"issue":"30","key":"2025091211295703800_bib78","doi-asserted-by":"crossref","first-page":"9287","DOI":"10.1073\/pnas.1504025112","article-title":"Three-Dimensional Model of Surfactant Replacement Therapy","volume":"112","year":"2015","journal-title":"Proc. Natl. Acad. Sci. U. S. A."},{"issue":"1","key":"2025091211295703800_bib79","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1007\/s10494-018-9927-1","article-title":"Targeted Drug Delivery to Upper Airways Using a Pulsed Aerosol Bolus and Inhaled Volume Tracking Method","volume":"102","year":"2019","journal-title":"Flow, Turbul. Combust."},{"issue":"11","key":"2025091211295703800_bib80","doi-asserted-by":"crossref","first-page":"e0207711","DOI":"10.1371\/journal.pone.0207711","article-title":"Targeting Inhaled Aerosol Delivery to Upper Airways in Children: Insight From Computational Fluid Dynamics (CFD)","volume":"13","year":"2018","journal-title":"PLoS One"},{"issue":"2","key":"2025091211295703800_bib81","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1152\/jappl.1971.31.2.207","article-title":"Models of the Human Bronchial Tree","volume":"31","year":"1971","journal-title":"J. Appl. Physiol."},{"key":"2025091211295703800_bib82","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.ejps.2017.09.016","article-title":"An Efficient Computational Fluid-Particle Dynamics Method to Predict Deposition in a Simplified Approximation of the Deep Lung","volume":"113","year":"2018","journal-title":"Eur. J. Pharm. Sci."},{"issue":"6","key":"2025091211295703800_bib83","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1115\/1.1406949","article-title":"Liquid Plug Flow in Straight and Bifurcating Tubes","volume":"123","year":"2001","journal-title":"ASME J. Biomech. Eng."},{"issue":"5","key":"2025091211295703800_bib84","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1115\/1.1992529","article-title":"Effect of Gravity on Liquid Plug Transport Through an Airway Bifurcation Model","volume":"127","year":"2005","journal-title":"ASME J. Biomech. Eng."},{"key":"2025091211295703800_bib85","doi-asserted-by":"crossref","first-page":"110458","DOI":"10.1016\/j.jbiomech.2021.110458","article-title":"Towards Homogenization of Liquid Plug Distribution in Reconstructed 3D Upper Airways of the Preterm Infant","volume":"122","year":"2021","journal-title":"J. Biomech."},{"key":"2025091211295703800_bib86","doi-asserted-by":"crossref","first-page":"120307","DOI":"10.1016\/j.ijpharm.2021.120307","article-title":"A 3D Printed Human Upper Respiratory Tract Model for Particulate Deposition Profiling","volume":"597","year":"2021","journal-title":"Int. J. Pharm."},{"issue":"5","key":"2025091211295703800_bib87","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1115\/1.2246235","article-title":"Effects of Inertia and Gravity on Liquid Plug Splitting at a Bifurcation","volume":"128","year":"2006","journal-title":"ASME J. Biomech. Eng."},{"issue":"9","key":"2025091211295703800_bib88","doi-asserted-by":"crossref","first-page":"091012","DOI":"10.1115\/1.4040456","article-title":"Engineered Airway Models to Study Liquid Plug Splitting at Bifurcations: Effects of Orientation and Airway Size","volume":"140","year":"2018","journal-title":"ASME J. Biomech. Eng."},{"issue":"6","key":"2025091211295703800_bib89","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1007\/s10439-019-02242-z","article-title":"A Three-Dimensional Model of Human Lung Airway Tree to Study Therapeutics Delivery in the Lungs","volume":"47","year":"2019","journal-title":"Ann. Biomed. Eng."},{"issue":"2","key":"2025091211295703800_bib90","doi-asserted-by":"crossref","first-page":"021006","DOI":"10.1115\/1.4055428","article-title":"A Quantitative Study of Transport of Surfactant Boli in a Three-Dimensional Lung Model of Neonates","volume":"145","year":"2023","journal-title":"ASME J. Biomech. Eng."},{"issue":"2","key":"2025091211295703800_bib91","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.pedneo.2015.04.012","article-title":"Comparison of Three Different Administration Positions for Intratracheal Beractant in Preterm Newborns With Respiratory Distress Syndrome","volume":"57","year":"2016","journal-title":"Pediatr. Neonatol."},{"key":"2025091211295703800_bib92","doi-asserted-by":"crossref","first-page":"2450006","DOI":"10.1142\/S2737599424500063","article-title":"Design and Fabrication of a Three-Dimensional Asymmetric Neonate Lung Model to Study Surfactant Transport in Airways","volume":"11","year":"2024","journal-title":"Innovation Emerging Technol."},{"issue":"1","key":"2025091211295703800_bib93","first-page":"4","article-title":"On the Instability of Jets","volume":"s1\u201310","year":"1878","journal-title":"Proc. London Math. Soc."},{"issue":"1","key":"2025091211295703800_bib94","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1093\/ilar\/ilu003","article-title":"Lamb Model of Respiratory Syncytial Virus-Associated Lung Disease: Insights to Pathogenesis and Novel Treatments","volume":"55","year":"2014","journal-title":"ILAR J."},{"issue":"6","key":"2025091211295703800_bib95","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1203\/00006450-199606000-00005","article-title":"Surfactant Aerosol Treatment of Respiratory Distress Syndrome in the Spontaneously Breathing Premature Rabbit","volume":"39","year":"1996","journal-title":"Pediatr. Res."},{"issue":"10","key":"2025091211295703800_bib96","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1203\/00006450-198210000-00007","article-title":"Surfactant Supplementation in the Preterm Rabbit: Effects of Applied Volume on Compliance and Survival","volume":"16","year":"1982","journal-title":"Pediatr. Res."},{"issue":"5","key":"2025091211295703800_bib97","doi-asserted-by":"crossref","first-page":"1955","DOI":"10.1152\/jappl.2001.90.5.1955","article-title":"A Rat Lung Model of Instilled Liquid Transport in the Pulmonary Airways","volume":"90","year":"2001","journal-title":"J. Appl. Physiol."},{"issue":"37","key":"2025091211295703800_bib98","doi-asserted-by":"crossref","first-page":"11530","DOI":"10.1073\/pnas.1512613112","article-title":"Targeted Delivery of Liquid Microvolumes Into the Lung","volume":"112","year":"2015","journal-title":"Proc. Natl. Acad. Sci."}],"container-title":["Journal of Biomechanical Engineering"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/asmedigitalcollection.asme.org\/biomechanical\/article-pdf\/147\/10\/100802\/7534896\/bio-25-1085.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/asmedigitalcollection.asme.org\/biomechanical\/article-pdf\/147\/10\/100802\/7534896\/bio-25-1085.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T15:30:17Z","timestamp":1757691017000},"score":1,"resource":{"primary":{"URL":"https:\/\/asmedigitalcollection.asme.org\/biomechanical\/article\/147\/10\/100802\/1221912\/Models-of-Surfactant-Replacement-Therapy-in"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,12]]},"references-count":98,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10,1]]}},"URL":"https:\/\/doi.org\/10.1115\/1.4069657","relation":{},"ISSN":["0148-0731","1528-8951"],"issn-type":[{"value":"0148-0731","type":"print"},{"value":"1528-8951","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,12]]},"article-number":"100802"}}