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Neonatal respiratory distress syndrome is a potentially life-threatening condition that is often treated with the delivery of exogenous surfactants through a process called surfactant replacement therapy. This therapy includes the administration of the liquid surfactant through an endotracheal tube and mechanical ventilation. Due to the difficulty of imaging neonate lungs during this therapy, the success of surfactant delivery is often determined by observational techniques and evaluation of blood oxygen levels. The limitation of imaging creates challenges in evaluating the distribution of surfactant in airways. To address this limitation, we designed a computational, eight-generation, asymmetric neonate lung model using morphometric data to mimic the geometric structure of the human airway tree and fabricated it using an additive manufacturing technique. We used our model to study two-aliquot delivery of a clinically rated liquid surfactant under two different orientations to evaluate its distribution in airways. Our study offers a complex lung airway tree design that mimics the native geometry of the human airway tree to enable studies of therapeutics transport in airways. 

Abstract Neonatal respiratory distress syndrome is mainly treated with the intratracheal delivery of pulmonary surfactants. The success of the therapy depends on the uniformity of distribution and efficiency of delivery of the instilled surfactant solution to the respiratory zone of the lungs. Direct imaging of the surfactant distribution and quantifying the efficiency of delivery is not feasible in neonates. To address this major limitation, we designed an eight-generation computational model of neonate lung airway tree using morphometric and geometric data of human lungs and fabricated it using additive manufacturing. Using this model, we performed systematic studies of delivery of a clinical surfactant either at a single aliquot or at two aliquots under different orientations of the airway tree in the gravitational space to mimic rolling a neonate on their side during the procedure. Our study offers novel insights into effects of the orientation of the lung airways and presence of a pre-existing surfactant film on how the instilled surfactant solution distributes in airways.