Synthetic Surfactant Replacement Therapy Decreases Estimated Pulmonary Artery Pressure in Respiratory Distress Syndrome

Kääpä, Pietari; Kero, Pentti; Saraste, Markku

doi:10.1001/archpedi.1992.02160200083033

Cited by 10 publications

(2 citation statements)

References 13 publications

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“…Synthetic surfactant replacement in infants with RDS reduces pulmonary vascular resistance, resulting in a significant but transitory reduction in pulmonary arterial pressure and an increase in ductal flow velocity [155,156]. The mean arterial blood pressure is decreased by 9.3 mmHg after surfactant adjustment [123].…”

Section: Complications In Surfactant Therapymentioning

confidence: 99%

The Pulmonary Surfactant System: Biochemical and Clinical Aspects

Creuwels

Golde

Haagsman

1997

Lung

282

188

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Abstract. This article starts with a brief account of the history of research on pulmonary surfactant. We will then discuss the morphological aspects and composition of the pulmonary surfactant system. We describe the hydrophilic surfactant proteins A and D and the hydrophobic surfactant proteins B and C, with focus on the crucial roles of these proteins in the dynamics, metabolism, and functions of pulmonary surfactant. Next we discuss the major disorders of the surfactant system. The final part of the review will be focused on the potentials and complications of surfactant therapy in the treatment of some of these disorders. It is our belief that increased knowledge of the surfactant system and its functions will lead to a more optimal composition of the exogenous surfactants and, perhaps, widen their applicability to treatment of surfactant disorders other than neonatal respiratory distress syndrome.Key words: Surfactant protein-Pulmonary surfactant-Respiratory distress syndrome. HistoryResearch on surfactant goes back to 1929 when von Neergaard published the first paper about the difference in pressure needed to inflate lungs with air or with liquid [333]. He found that the pressure necessary for filling the lungs with air was higher than when the lungs were filled with liquid. To explain this result he stated that the alveoli were stabilized by lowering the naturally high surface tension of the air/water interface. In 1946 Thannhauser and co-workers reported that lung tissue has a remarkably high content of the lipid dipalmityl lecithin (current name, dipalmitoylphosphatidylcholine)Offprint requests to: Henk P. Haagsman.

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Section: Complications In Surfactant Therapymentioning

confidence: 99%

The Pulmonary Surfactant System: Biochemical and Clinical Aspects

Creuwels

Golde

Haagsman

1997

Lung

282

188

View full text Add to dashboard Cite

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“…By 24 hours, 6% still showed no response and died, 11% showed a mild response and 83% a good response; however, half of these relapsed. Kaapa et al 33 evaluated the effects of the synthetic surfactant Exosurf as replacement therapy on the pulmonary artery pressure in 10 infants with respiratory distress syndrome; they received two or four doses of the synthetic surfactant. Surfactant instillation decreased pulmonary artery pressure significantly on 17 of 18 occasions, but did not change systemic blood pressure, but pulmonary artery pressure measured on 9 occasions returned to the preterm level.…”

Section: Effects Of Synthetic Surfactants On Preterm Infant Lungsmentioning

confidence: 99%

Effects of surfactants on preterm infant lungs

Pacifici¹

2015

Medical Express

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How does exogenous surfactant really work?

Milner

1995

Eur J Pediatr

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The finding of a lag of up to 24 h between the response to exogenous surfactant in infants with respiratory disease syndrome as assessed by blood gases and improvements in respiratory system compliance has generated considerable interest. Studies have shown that there is rapid increase in functional residual capacity after natural surfactant and a less dramatic rise in effective pulmonary blood flow. These changes in blood flow are not associated with a sustained fall in pulmonary artery flow or pressure indicating that the main improvement in oxygenation results from a reduction in intrapulmonary shunting. Recent studies have shown that natural surfactant does produce rapid increases in lung compliance but only if the expired gases are vented to ambient rather than to positive end expiratory pressures. Thus the mechanical effects of natural surfactant are initially largely limited to the part of the tidal volume which is close to the functional residual capacity.

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Synthetic Surfactant Replacement Therapy Decreases Estimated Pulmonary Artery Pressure in Respiratory Distress Syndrome

Cited by 10 publications

References 13 publications

The Pulmonary Surfactant System: Biochemical and Clinical Aspects

The Pulmonary Surfactant System: Biochemical and Clinical Aspects

Effects of surfactants on preterm infant lungs

How does exogenous surfactant really work?

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