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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

Surfactant application during extracorporeal membrane oxygenation improves lung volume and pulmonary mechanics in

Michael Hermon1, Gudrun Burda, Christoph Male

  • 1Division of Neonatology and Pediatric Intensive Care, University Children's Hospital, Medical University of Vienna, Austria. michael.hermon@meduniwien.ac.at

Critical Care (London, England)
|November 11, 2005
PubMed

Insights

Surfactant administration during extracorporeal membrane oxygenation (ECMO) in children significantly improved lung function and mechanics. This finding suggests potential benefits for respiratory support in critically ill pediatric patients.

Area of Science:

  • Pediatric Critical Care Medicine
  • Neonatology
  • Pulmonology

Background:

  • Extracorporeal membrane oxygenation (ECMO) is a life-support measure for severe respiratory failure in children.
  • Optimizing lung function during ECMO is crucial for patient outcomes.
  • The role of exogenous surfactant in improving respiratory mechanics during pediatric ECMO requires further investigation.

Purpose of the Study:

  • To evaluate the impact of surfactant administration on lung volume, pulmonary mechanics, and radiographic findings in pediatric patients undergoing ECMO.
  • To compare outcomes between children receiving surfactant during ECMO and a control group.

Main Methods:

  • Retrospective chart review of pediatric patients in a pediatric intensive care unit (PICU).
  • Comparison of seven patients who received surfactant (group S) with six matched controls (group C) during ECMO.
  • Extraction of demographic data, ventilator settings, tidal volume, respiratory system compliance, and ECMO flow.
  • Radiographic scoring by blinded radiologists and statistical analysis using repeated-measures analysis of variance.

Main Results:

  • Surfactant administration in group S led to a near doubling of mean tidal volume (186.2%) and a significant increase in compliance (176.1%) compared to baseline.
  • No significant changes in tidal volume or compliance were observed in the control group (group C).
  • Chest radiograph scores tended to improve, and ECMO flow tended to decrease post-surfactant in group S, with no significant impact on mortality.

Conclusions:

  • Surfactant application during ECMO in children with respiratory failure may improve lung function and mechanics.
  • These preliminary findings suggest a potential benefit of surfactant therapy in this patient population.
  • Further confirmation through prospective studies is warranted to solidify these conclusions.
Abstract

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