BOVINE SURFACTANT IN THE TREATMENT OF SEVERE ARDS (PAO2/FIO2 RATIO &lt; 100) IN CHILDREN - A MULTICENTER RANDOMIZED STUDY

Möller, Jens; Vossbeck, S; Roll, Claudia; Schaible, T; Schiffmann, Holger; Kohl, M.; Reiss, I.; Paul, Thomas M.; Hentschel, Roland; Bindl, Lutz; Roth, Bernhard; Schrod, Lothar

doi:10.1097/00003246-199912001-00003

Cited by 3 publications

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“…Only one small controlled trial in infants and children with ARDS of different aetiology has been published recently (15). A European controlled trial with a bovine surfactant is currently being evaluated (16). Both studies demonstrated improvement in oxygenation without improved survival.…”

Section: Discussionmentioning

confidence: 99%

Surfactant improves oxygenation in infants and children with pneumonia and acute respiratory distress syndrome

et al. 2002

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Aim: Pneumonia in childhood may be associated with surfactant dysfunction and severe acute respiratory distress syndrome (ARDS). The aim of this study was to investigate the effects of surfactant treatment on oxygenation in 8 infants (age range: 1 mo to 13 y) with severe respiratory failure owing to viral, bacterial or Pneumocystis Carinii pneumonia. Methods and results: Instillation of a modified porcine surfactant (Curosurf®) improved gas exchange immediately. Median paO2/FiO2 increased from 66 to 140mmHg (8.8–18.7 kPa; p < 0.01) within 1 h of surfactant treatment. Seven of the 8 patients received multiple surfactant doses. Four patients (50%) died 3–62 d after surfactant treatment. However, 6 patients (75%) were immunodeficient, so that the observed mortality rate was mainly due to the underlying disease. Conclusion: Surfactant dysfunction probably plays a role in the pathophysiology of severe paediatric ARDS triggered by pneumonia, as it was found that surfactant instillation rapidly improved gas exchange in the majority of the affected infants in our study. Larger randomized controlled studies are necessary to evaluate the effects of surfactant treatment on morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

Surfactant improves oxygenation in infants and children with pneumonia and acute respiratory distress syndrome

et al. 2002

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Surfactant improves oxygenation in infants and children with pneumonia and acute respiratory distress syndrome

et al. 2002

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Persurf, a New Method to Improve Surfactant Delivery: A Study in Surfactant Depleted Rats

Burkhardt¹,

Kraft

Ochs

et al. 2012

PLoS ONE

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PurposeExogenous surfactant is not very effective in adults with ARDS, since surfactant does not reach atelectatic alveoli. Perfluorocarbons (PFC) can recruit atelectatic areas but do not replace impaired endogenous surfactant. A surfactant-PFC-mixture could combine benefits of both therapies. The aim of the proof-of-principal-study was to produce a PFC-in-surfactant emulsion (Persurf) and to test in surfactant depleted Wistar rats whether Persurf achieves I.) a more homogenous pulmonary distribution and II.) a more homogenous recruitment of alveoli when compared with surfactant or PFC alone.MethodsThree different PFC were mixed with surfactant and phospholipid concentration in the emulsion was measured. After surfactant depletion, animals either received 30 ml/kg of PF5080, 100 mg/kg of stained (green dye) Curosurf™ or 30 ml/kg of Persurf. Lungs were fixated after 1 hour of ventilation and alveolar aeration and surfactant distribution was estimated by a stereological approach.ResultsPersurf contained 3 mg/ml phospholipids and was stable for more than 48 hours. Persurf-administration improved oxygenation. Histological evaluation revealed a more homogenous surfactant distribution and alveolar inflation when compared with surfactant treated animals.ConclusionsIn surfactant depleted rats administration of PFC-in-surfactant emulsion leads to a more homogenous distribution and aeration of the lung than surfactant alone.

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BOVINE SURFACTANT IN THE TREATMENT OF SEVERE ARDS (PAO2/FIO2 RATIO < 100) IN CHILDREN - A MULTICENTER RANDOMIZED STUDY

Cited by 3 publications

References 0 publications

Surfactant improves oxygenation in infants and children with pneumonia and acute respiratory distress syndrome

Surfactant improves oxygenation in infants and children with pneumonia and acute respiratory distress syndrome

Surfactant improves oxygenation in infants and children with pneumonia and acute respiratory distress syndrome

Persurf, a New Method to Improve Surfactant Delivery: A Study in Surfactant Depleted Rats

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