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Updated: May 31, 2026
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
Severe airway obstruction during surfactant administration using a standardized protocol: a prospective,
A Tarawneh1, J Kaczmarek, M N Bottino
1Department of Pediatrics, McMaster University, Hamilton, Ontario and Mutah University, Karak, Jordan.
Summary
This study found a high rate of severe airway obstruction (SAO) during surfactant delivery in infants. Protocol adjustments, including increased inspiratory pressures for extreme low birth weight (ELBW) infants, are recommended to improve safety.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Respiratory Care
Background:
- Surfactant replacement therapy is crucial for treating respiratory distress syndrome in preterm infants.
- Standardized protocols are essential for safe surfactant administration and complication management.
- Adverse events during surfactant delivery require careful evaluation to optimize patient outcomes.
Purpose of the Study:
- To assess the incidence of adverse effects during surfactant administration using a standardized protocol.
- To identify specific complications and their severity in infants receiving surfactant.
- To inform protocol modifications for enhanced safety during respiratory support.
Main Methods:
- A standardized surfactant delivery protocol was implemented for six months.
- Prospective recording of vital signs and ventilatory parameters during the procedure.
- Infants were categorized into no, minor, or major complication groups based on observed events.
Main Results:
- Out of 39 infants receiving surfactant, 19 experienced complications (11 minor, 8 major).
- Severe airway obstruction (SAO) was the most frequent major complication, particularly in extreme low birth weight (ELBW) infants with severe lung disease.
- Two cases of persistent pulmonary hypertension were noted in infants exceeding 1000g birth weight.
Conclusions:
- The study highlights a significant occurrence of SAO during surfactant delivery.
- Findings support protocol revisions to include more rapid increases in positive inspiratory pressures for ELBW infants experiencing SAO.
- Optimized management strategies are needed to mitigate adverse events associated with surfactant therapy.
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