Bronchoscopic surfactant administration in pediatric patients with persistent lobar atelectasis

Related Experiment Video

Updated: Aug 15, 2026

Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome (ARDS)
06:22

Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome (ARDS)

Published on: April 7, 2021

Martin F Krause1, Philipp von Bismarck, Hans C Oppermann

  • 1Department of Pediatrics, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany. m.krause@pediatrics.uni-kiel.de

Respiration; International Review of Thoracic Diseases
|October 6, 2005
PubMed

Insights

Bronchoscopic surfactant application can improve oxygenation and lung mechanics in pediatric patients with persistent lobar atelectasis. This intervention facilitates early extubation, offering a safe and effective treatment for critical respiratory conditions.

Area of Science:

  • Pediatric critical care medicine
  • Pulmonology
  • Bronchoscopy and interventional pulmonology

Background:

  • Persistent lobar atelectasis in pediatric patients on mechanical ventilation impairs gas exchange and lung mechanics.
  • Common causes include airway obstruction and surfactant deficiency, prolonging mechanical ventilation.
  • Effective treatment strategies for pediatric atelectasis are crucial for improving patient outcomes.

Purpose of the Study:

  • To evaluate the efficacy of bronchoscopic suctioning and surfactant administration in treating pediatric lobar atelectasis.
  • To assess improvements in oxygenation, ventilation, chest X-ray scores, and time to extubation.
  • To determine the safety and recurrence rates of this intervention.

Main Methods:

  • A prospective study involving five pediatric patients (7 months to 15 years) with heterogeneous lung diseases and lobar atelectasis.
  • Bronchoscopic instillation of a diluted surfactant preparation (Curosurf, 5-10 mg/ml, 120-240 mg total dose) into affected lung segments.
  • Monitoring of gas exchange, respiratory rate, chest X-ray findings, and extubation status.

Main Results:

  • All five mechanically ventilated patients were successfully extubated within 24 hours post-intervention.
  • Bronchoscopic surfactant application was performed without adverse effects.
  • Significant improvements were observed in oxygenation, respiratory rate, and radiographic resolution of atelectasis.
  • No recurrence of atelectasis was noted during the follow-up period.

Conclusions:

  • Bronchoscopic surfactant application is a safe and effective treatment for pediatric lobar atelectasis.
  • The procedure leads to rapid clinical improvement, including enhanced gas exchange and early extubation.
  • This minimally invasive approach offers a promising therapeutic option for improving respiratory mechanics in critically ill children.

Related Concept Videos

Breathing01:05

Breathing

The process of breathing, inhaling and exhaling, involves the coordinated movement of the chest wall, the lungs, and the muscles that move them. Two muscle groups with important roles in breathing are the diaphragm, located directly below the lungs, and the intercostal muscles, which lie between the ribs. When the diaphragm contracts, it moves downward, increasing the volume of the thoracic cavity and creating more room for the lungs to expand. When the intercostal muscles contract, the ribs...
Acute Respiratory Failure-V01:29

Acute Respiratory Failure-V

The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Pulmonary Cycle: Exhalation01:17

Pulmonary Cycle: Exhalation

In terms of human respiration, the act of expelling air, known as exhalation (or expiration), operates on the principle of pressure gradients. During expiration, the pressure within the lungs exceeds that of the surrounding atmosphere. Under normal conditions, quiet breathing involves passive exhalation and is free of muscular contractions. This is because the exhalation process is driven by the natural elastic recoil of the lungs and chest wall, both of which have an inherent tendency to...
Inhaled Medications01:23

Inhaled Medications

Inhaled medications are crucial for managing chronic obstructive pulmonary disease (COPD) and asthma. They are essential for effective treatment and control, ensuring optimal respiratory health and well-being. Inhaled medication delivers drugs directly to the lungs, providing a rapid onset of action and reducing systemic side effects compared to oral or injectable medications. Three primary types of inhalation devices are used to administer these medications: nebulizers, metered-dose inhalers...