Surfactant treatment for acute respiratory distress syndrome
Pediatric Intensive
Care Unit, Gregorio Marañon University General Hospital,
c/Puentecesures 1.B 1° B, 28029 Madrid, Spain
Correspondence to: Dr López-Herce. email: uciped{at}ippp.hggm.es
Accepted 24
September 1998
OBJECTIVE
To determine
prospectively the efficacy of surfactant in acute respiratory distress syndrome.
STUDY
DESIGNTwenty patients, 1 month to 16 years of
age, diagnosed with an acute pulmonary disease with severe hypoxaemia
(PaO2/FiO2 < 100) (13 with systemic or
pulmonary disease and seven with cardiac disease) were treated with one
to six doses of 50-200 mg/kg of porcine surfactant administered
directly into the trachea. The surfactant was considered to be
effective when the PaO2/FiO2 improved by
> 20%.
RESULTSAfter initial
surfactant administration the PaO2/FiO2
increased significantly in patients with systemic or pulmonary disease from 68 to 111, and the oxygenation index (OI) diminished significantly from 36.9 to 27.1. The PaO2/FiO2 and OI did not
improve in children with cardiac disease. The improvement of the
patients who survived was greater than that of those who died.
CONCLUSIONSSurfactant
moderately improves oxygenation in some children with severe acute
respiratory distress syndrome secondary to pulmonary or systemic disease.
© 1999 by Archives of Disease in Childhood
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