Open AccessSurfactant therapy to facilitate weaning in paediatric patients dependent on extacorporeal membrane oxygenation
Author(s) -
Nikhil Achanta,
J. Vujcikova,
Sanjiv Nichani,
Sanjiv Nichani
Publication year - 2020
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2020-237012
Subject(s) - extracorporeal membrane oxygenation , medicine , weaning , pulmonary surfactant , acute respiratory distress , oxygenation , anesthesia , intensive care medicine , adverse effect , respiratory distress , surfactant therapy , lung , physics , thermodynamics , pregnancy , genetics , biology , gestational age
We are reporting two paediatric cases with severe adenoviral acute respiratory distress syndrome with viral counts of 308 and 119 million copies/mL respectively, who required venoarterial extracorporeal membrane oxygenation (ECMO) support for nearly 3 weeks. They were static on ECMO and had shown a complete lack of response to all therapeutic interventions aimed at decreasing ECMO support. To facilitate weaning from ECMO, they received 2-3 doses of surfactant. This led to dramatic improvement in pulmonary compliance, oxygenation and chest X-ray. They were both weaned off ECMO within 24 hours of receiving surfactant. Surfactant was well tolerated, with no adverse effects. In both cases, weaning from ECMO was possible only after surfactant administration. From our experience, we conclude that surfactant administration is a potentially safe and effective treatment modality that helps weaning from ECMO and should be considered in patients who are dependent on ECMO for long duration.