Bovine surfactant therapy for patients with acute respiratory distress syndrome
| Autor: | Leonard D. Hudson, T J Gregory, G Z Cai, A J Gold, M A Moxley, K P Steinberg, P Newton, B R Mitchell, R D Hite, Robert M. Smith, Roger G. Spragg, W J Longmore, T M Hyers, C Crim, J E Gadek |
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| Rok vydání: | 1997 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine ARDS Pilot Projects Critical Care and Intensive Care Medicine Surfactant therapy Pulmonary surfactant Animals Humans Medicine Prospective Studies Adverse effect Prospective cohort study Biological Products Respiratory Distress Syndrome Dose-Response Relationship Drug medicine.diagnostic_test Respiratory distress business.industry Respiratory disease Pulmonary Surfactants medicine.disease Respiration Artificial Instillation Drug Treatment Outcome Bronchoalveolar lavage Anesthesia Cattle Female business |
| Zdroj: | American Journal of Respiratory and Critical Care Medicine. 155:1309-1315 |
| ISSN: | 1535-4970 1073-449X |
| Popis: | Lung surfactant is deficient in patients with acute respiratory distress syndrome (ARDS). We performed a randomized, prospective, controlled, open-label clinical study of administration of a bovine surfactant to patients with ARDS to obtain preliminary information about its safety and efficacy. Patients received either surfactant by endotracheal instillation in addition to standard therapy or standard therapy only. Three different groups of patients receiving surfactant were studied: patients receiving up to eight doses of 50 mg phospholipids/kg, those receiving up to eight doses of 100 mg phospholipids/kg, and those receiving up to four doses of 100 mg phospholipids/kg. Outcome measures included ventilatory support parameters, arterial blood gases, organ system failures, bronchoalveolar lavage (BAL) analyses, immunologic analyses, survival, and adverse events during the 28-d study period. Fifty-nine study patients were evaluable; 43 in the surfactant group and 16 in the control group. The FI(O2) at 120 h after treatment began was significantly decreased only for patients who received up to four doses of 100 mg phospholipids/kg surfactant as compared with control patients (p = 0.011). Mortality in the same group of patients was 18.8%, as compared with 43.8% in the control group (p = 0.075). The surfactant instillation was generally well tolerated, and no safety concerns were identified. This pilot study presents preliminary evidence that surfactant might have therapeutic benefit for patients with ARDS, and provides rationale for further clinical study of this agent. |
| Databáze: | OpenAIRE |
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