Uso de surfactante exógeno no tratamento da bronquiolite viral grave: relato de caso

Vitola, Luciano Schneider; Piva, Jefferson Pedro; García, Pedro Celiny Ramos; Bruno, Francisco; Miranda, Ana Paula de Oliveira; Martha, Vanessa Feller

doi:10.1590/s0021-75572001000200016

Cited by 3 publications

(3 citation statements)

References 16 publications

(57 reference statements)

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“…Vitola et al 53 have described the use of surfactant in a patient with severe acute viral bronchiolitis who needed high ventilation parameters to keep a PaO 2 of 60-80 mmHg. The use of surfactant (Exosurf Glaxo -50 mmHg) was followed by an improvement in ventilation and a reduction in the parameters used for that patient.…”

Section: Severe Viral Bronchiolitismentioning

confidence: 99%

Terapia com surfactante pulmonar exógeno em pediatria

Freddi

Filho²,

Fiori³

2003

J. Pediatr. (Rio J.)

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Objective: To review current knowledge about the use of exogenous surfactants in the treatment of different lung diseases causing acute respiratory failure in children. Sources of data:This review is based on the authors' experience and on recent data retrieved from ONIA, Mdconsult, Medline and the Cochrane Database Library. Summary of the findings:In spite of the success of the use of exogenous surfactants in Respiratory Distress Syndrome (RDS) of the newborn, some questions remain unanswered, such as the optimal administration timing -either very early (prophylactic), based on gestational age or on quick tests of lung maturity, or later, when the clinical picture becomes unequivocal. In other severe diseases requiring ventilatory support, the use of surfactants is still controversial, and data in the literature are limited and conflicting. However, successful use in several other diseases has been reported. Recent studies have focused on surfactant inactivation by substances that can be found in the airways. New surfactants with the addition of substances to control inhibition, such as polyethyleneglycol, are being tested for diseases in which inactivation seems to be a significant factor. Conclusions:Therapy with exogenous surfactants, even as a treatment for RDS, has not been thoroughly investigated. Further studies should be conducted to improve surfactants -mainly their resistance to inhibition -and the treatment of diseases other than RDS.J Pediatr (Rio J) 2003;79 (Suppl 2):S205-S12: Exogenous surfactant, respiratory failure, intensive care, respiratory distress syndrome.

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Section: Severe Viral Bronchiolitismentioning

confidence: 99%

Terapia com surfactante pulmonar exógeno em pediatria

Freddi

Filho²,

Fiori³

2003

J. Pediatr. (Rio J.)

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“…Vitola et al 53 , em nosso meio, descrevem a utilização de surfactante em um paciente com bronquiolite viral aguda grave que necessitava de elevados parâmetros ventilatórios para manter PaO 2 de 60-80 mmHg. A utilização de surfactante (Exosurf Glaxo -50 mmHg) seguiu-se de melhora da oxigenação e possibilidade de diminuição dos parâmetros utilizados no paciente.…”

Section: Bronquiolite Viral Graveunclassified

Exogenous surfactant therapy in pediatrics

Freddi¹,

Filho²,

Fiori³

2003

J Pediatr (Rio J)

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ResumoObjetivo: Revisar o estágio atual do conhecimento sobre a utilização do surfactante exógeno nas diferentes doenças pulmonares que levam à insuficiência respiratória aguda em crianças. Fontes dos dados:Este manuscrito baseia-se na experiência clínica dos autores sobre o assunto e na revisão da literatura recente através de consulta aos bancos de dados ONIA, Mdconsult, Medline e Cochrane Database Library. Síntese dos dados:Apesar do sucesso obtido com a utilização do surfactante exógeno na síndrome de desconforto respiratório do recém-nascido, questões permanecem indefinidas, como o momento do seu emprego, muito precoce (profilático), baseado na idade gestacional ou em testes rápidos de maturidade pulmonar, ou então mais tardiamente, após o quadro clínico instalado. Em outras patologias graves que levam à insuficiência respiratória grave com necessidade de suporte ventilatório, o seu uso ainda é controverso, e os dados da literatura são limitados e conflitantes. Porém, relatos de uso clínico em várias destas situações, com sucesso, têm sido freqüentes. A pesquisa em surfactante tem-se centrado ultimamente na sua inativação por várias substâncias que podem estar presentes na via aérea. Nas patologias em que a inativação parece ser um fator importante, novos surfactantes com adição de adjuvantes para reverter a tendência à inativação (por exemplo: polietilenoglicol) estão atualmente em fase de testes. Conclusões:A terapia com surfactante exógeno ainda não é um tema esgotado, nem mesmo na SDR. Os surfactantes podem ser ainda aperfeiçoados, sobretudo para resistir à inibição, e as formas de utilização em outras doenças que não a SDR deverão ser aperfeiçoadas.J Pediatr (Rio J) 2003;79(Supl.2):S205-S212: Surfactante exógeno, insuficiência respiratória, cuidados intensivos, síndrome de desconforto respiratório. AbstractObjective: To review current knowledge about the use of exogenous surfactants in the treatment of different lung diseases causing acute respiratory failure in children. Source of data:This review is based on the authors' experience and on recent data retrieved from ONIA, Mdconsult, Medline and the Cochrane Database Library. Summary of the findings:In spite of the success of the use of exogenous surfactants in Respiratory Distress Syndrome (RDS) of the newborn, some questions remain unanswered, such as the optimal administration timing -either very early (prophylactic), based on gestational age or on quick tests of lung maturity, or later, when the clinical picture becomes unequivocal. In other severe diseases requiring ventilatory support, the use of surfactants is still controversial, and data in the literature are limited and conflicting. However, successful use in several other diseases has been reported. Recent studies have focused on surfactant inactivation by substances that can be found in the airways. New surfactants with the addition of substances to control inhibition, such as polyethyleneglycol, are being tested for diseases in which inactivation seems to be a significant factor. Conclusio...

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“…Several studies have shown lavage with diluted surfactant to be more therapeutically eff ective than conventional bolus or aerosol therapy (11)(12)(13). However, studies on pediatric and adult patients with diff erent indications for exogenous surfactant application have given contradictory results (14)(15)(16)(17)(18)(19)(20)(21)(22). For example, the use of surfactant shows promise for treating severe bronchiolitis and acute respiratory distress syndrome (ARDS) (23), but its use in patients with bronchopneumonia remains controversial.…”

Section: Introductionmentioning

confidence: 99%