Inhaled dry salt micro particles in the treatment of bronchopulmonary dysplasia: a five case series report

Background. Despite current medical ad-vances, to this day there is no single medi-cal intervention to effectively prevent or treat bronchopulmonary dysplasia (BPD) in both preterm and term infants. Along with protective ventilation strategies, vari-ous drugs are being used or are being re-searched at this very moment, with the sole purpose of improving the general outcome for these patients. Inhaled dry salt micro particles therapy is now one of them. Materials and methods. This report pre-sents five patients, diagnosed with severe BPD. All of them received, complemen-tary to classical BPD management and respiratory support, continuous inhaled dry salt micro particles, via SaltMed car-tridges, for a period of 12 to 30 days. After only 24 hours of administration, we were able to observe a significant improvement in respiratory function and dynamics. It was possible to use a lower fraction of in-spired oxygen (FiO2), mean airway pres-sure (MAP) and peak inspiratory pressure (PIP) in all mechanically ventilated pa-tients. Higher tidal volumes were recorded and we observed improvement in oxygen-ation indexes.

Conclusion. Continuously inhaled dry salt micro particles, administered complemen-tary to classic BPD management, could improve respiratory and overall morbid-ity and mortality in infants with any form of BPD. Further study of these possible effects is needed, as there is no data pub-lished on this matter so far.

bronchopulmonary dysplasia (BPD), inhaled dry salt micro particles, oxy-genation index (OI), fraction of inspired ox-ygen (FiO2), mean airway pressure (MAP).

1. Stark AR, Redding G. Pathogenesis and clinical features of bronchopulmonary dysplasia. UpToDate, Wolters Kluwer

2. Mourani PM, Abman SH. Pulmonary vascular disease in bronchopulmonary dysplasia: pulmonary hypertension and beyond. Curr Opin Pediatr 2013 Jun;25(3):329-37.

3. Stoll BJ, Hansen NI, Bell EF, Shankaran S, Laptook AR, Walsh MC, et al. National Institute of Child Health and Human Development Neonatal Research Network. Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network.

4. Pediatrics 2010;126(3):443.

5. Walsh MC, Szefler S, Davis J, Allen M, Van Marter L, Abman S, et al.

6. Summary proceedings from the bronchopulmonary dysplasia group. Pediatrics 2006;117(3 Pt 2):S52.

7. Ann R Stark, Richard Martin, Gregory Redding. Prevention of bronchopulmonary dysplasia, UpToDate, Wolters Kluwer

8. Ann R Stark, Richard Martin, Gregory Redding. Management of bronchopulmonary dysplasia, UpToDate, Wolters Kluwer

9. Bancalari E, Wilson-Costello D, Iben SC. Management of infants with bronchopulmonary dysplasi in Nort America. Early Hum Dev 2005;81(2):171-9.

10. Shinwell ES, Portnov I, Meerpohl J, Karen T, Bassler D. Use of inhaled costicosteroids for the prevention and/orbronchopulmonary dysplasia in preterm infants: asystematic review protocol. Sys Rev 2015 Sept 25;4(1):127.doi:10.1186/s 13643-015-0108-1

11. Abman SH, Groothius JR. Pathophysiology and treatment of bronchopulmonary dysplasia. Pediatr Clin Nort Am 1994;41(2):277-315.

12. Jasmine Shani Pharma D, Stephanie Phelps Pharma D. Nebulized Furosemide in the treatment of bronchopulmonary dysplasia in preterm infants. J Peditr Pharmacol Ther 2011;16(1):14-22.

13. Stelmach I, Jerzynska J, Bobrowska M, Brzozowska A, Majak P, Kuna P. The effect of inhaled heparin on airway responsiveness to metacholine in asthmatic children. Pol Arch Med Wewn 2001 Jul :106(1);567-72.

14. Gandia F, Rouatbi S, Lotiri I, Guenard H, Tabka Z. Inhaled magnesium floride reverse bronchospasma. J Smooth Muscle Res 2010;46(3):157-64.

15. Zhao W, Rouatbi S, Tabka Z, Guenard H. Inhaled sodium floride decreses airway resposiveness to acetylcholine analogs in vivo. Respir Physiol Neurobiol 2002 Aug 1;131(3):245-53.