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Surfactant treatment for acute respiratory distress syndrome
J López-Herce1, N de Lucas, A Carrillo
1Pediatric Intensive Care Unit, Gregorio Marañon University General Hospital, Madrid, Spain. uciped@ippp.hggm.es
Objective:
To determine prospectively the efficacy of surfactant in acute respiratory distress syndrome.
Study Design:
Twenty patients, 1 month to 16 years of age, diagnosed with an acute pulmonary disease with severe hypoxaemia (PaO2/FiO2 < 100) (13 with systemic or pulmonary disease and seven with cardiac disease) were treated with one to six doses of 50-200 mg/kg of porcine surfactant administered directly into the trachea. The surfactant was considered to be effective when the PaO2/FiO2 improved by > 20%.
Results:
After initial surfactant administration the PaO2/FiO2 increased significantly in patients with systemic or pulmonary disease from 68 to 111, and the oxygenation index (OI) diminished significantly from 36.9 to 27.1. The PaO2/FiO2 and OI did not improve in children with cardiac disease. The improvement of the patients who survived was greater than that of those who died.
Conclusions:
Surfactant moderately improves oxygenation in some children with severe acute respiratory distress syndrome secondary to pulmonary or systemic disease.