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Selective bronchial instillation of surfactant has been suggested using a conventional tube introduced in one main bronchus or using a bilumen tube or via a bronchoscope. The advantages deriving from these methods are the delivery of large doses to distal regions of lung and the reduction of the total amount of dose instilled (cost reduction) . The disadvantages of these methods are connected with the complexity of procedures.
Marraro G, Galassini EM, Padovani EM. Biol Neonate 1998
Walmrath D, Gunther A, Ghofrani HA, Schermuly R, Schneider T, Am J Respir Crit Care Med 1996
Reiss I, Woessmann W, Kohl M, Ahrens P, Moeller JC, Gortner L. Biol Neonate 1999