[Surfactant administration in acute respiratory failure].

Area of Science:

• Pulmonology
• Critical Care Medicine
• Trauma Surgery

Background:

• Adult respiratory distress syndrome (ARDS) is a severe lung condition often resulting from trauma.
• Early management of traumatic lung injury is crucial for patient outcomes.

Observation:

• A 21-year-old male developed ARDS after a car accident with severe lung contusion and multiple rib fractures.
• Initial conventional ventilation strategies, including high-frequency and inverse-ratio ventilation, failed to improve respiratory function.

Findings:

• Administration of bovine surfactant preparation led to initial deterioration, likely due to bronchial crusting.
• Bronchoscopic aspiration of bronchial crusts resulted in progressive respiratory improvement, allowing reduction in oxygen support and PEEP.
• The patient achieved normalized ventilatory ratio within 14 days post-surfactant instillation.

Implications:

• Surfactant therapy, when combined with bronchoscopy for airway clearance, may be a viable treatment for ARDS post-trauma.
• This case highlights the potential benefit of exogenous surfactant in improving pulmonary function and aiding recovery in severe ARDS.
• Further research into surfactant therapy for traumatic ARDS is warranted.