Premium
Porcine‐derived surfactant treatment of severe bronchiolitis
Author(s) -
Luchetti M.,
Casiraghi G.,
Valsecchi R.,
Galassini E.,
Marraro G.
Publication year - 1998
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1998.tb05326.x
Subject(s) - medicine , bronchiolitis , mechanical ventilation , anesthesia , pulmonary surfactant , peak inspiratory pressure , ventilation (architecture) , fraction of inspired oxygen , oxygenation , respiratory system , tidal volume , physics , thermodynamics , mechanical engineering , engineering
Background : It is hypothesized that surfactant treatment helps to improve severe bronchiolitis by restoring surfactant system activity. This study aims to assess the effect of surfactant on gas exchange, peak inspiratory pressure and duration of mechanical ventilation and intensive care unit (ICU) stay in children with severe bronchiolitis. Methods : Twenty children with bronchiolitis requiring mechanical ventilation were randomly assigned to one of two groups (10 patients each). Group A was treated with continuous positive pressure ventilation (CPPV) plus surfactant. Group B was treated with CPPV only. Porcine‐derived surfactant, 50 mg/kg body weight, was instilled into the trachea. Arterial tension of oxygen/fraction of inspired oxygen (PaO 2 /FiO 2 ) ratio, arterial tension of carbon dioxide (PaCO 2 ), and peak inspiratory pressure (PIP) were assessed. Heart rate and non‐invasive arterial blood pressure were monitored. The duration of CPPV and the length of ICU stay were also recorded. Finally, the incidence of complications and the survival rate were assessed. Results : In group A, the PaO 2 /FiO 2 ratio significantly improved from 1 h and a reduction in PaCO 2 was noted from 12 h. A reduction of PIP was observed from 3 h. The duration of CPPV and the length of ICU stay were reduced in group A. No complications were reported in either group and all children survived. Conclusions : Surfactant treatment of severe bronchiolitis appeared to improve gas exchange, reduce PIP and shorten CPPV and ICU stay. However, these initial results must be confirmed by a larger and more rigorously controlled study.