Advertisement

Rationale for Exogenous Surfactant in Acute Respiratory Distress Syndrome

  • J. J. Haitsma
  • B. Lachmann
Conference paper

Abstract

Acute Respiratory Distress Syndrome (ARDS) is characterized by respiratory dysfunction including hypoxemia and decreased lung compliance. The definition for ARDS according to the American-European Consensus Conference on ARDS [1] stipulates: 1. acute onset; 2. PaO2 < 200 mmHg; 3. bilateral infiltrates as seen on a frontal chest radiograph; and 4. pulmonary artery wedge pressure < 18 mmHg or no clinical evidence of left atrial hypertension.

Keywords

Acute Respiratory Distress Syndrome Adult Respiratory Distress Syndrome Pulmonary Artery Wedge Pressure Aerosol Delivery Surfactant Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Bernard GR, Artigas A, Brigham KL et al (1994) Report of the American-European Consensus conference on acute respiratory distress syndrome: definitions, mechanisms, relevant outcomes, and clinical trial coordination. Consensus Committee. J Crit Care 9: 72-81Google Scholar
  2. 2.
    Luhr OR, Antonsen K, Karlsson M et al (1999) Incidence and mortality after acute respiratory failure and acute respiratory distress syndrome in Sweden, Denmark, and Iceland. The ARF Study Group. Am J Respir Crit Care Med 159: 1849-1861Google Scholar
  3. 3.
    Seeger W, Stohr G, Wolf HR et al (1985) Alteration of surfactant function due to protein leakage: special interaction with fibrin monomer. J Appl Physiol 58: 326 - 338PubMedGoogle Scholar
  4. 4.
    Lachmann B, Robertson B, Vogel J (1980) In vivo lung lavage as an experimental model of the respiratory distress syndrome. Acta Anaesthesiol Scand 24: 231 - 236PubMedCrossRefGoogle Scholar
  5. 5.
    Lachmann B, Jonson B, Lindroth M (1982) Modes of artificial ventilation in severe respiratory distress syndrome. Lung function and morphology in rabbits after wash-out of alveolar surfactant. Crit Care Med 10: 724-732Google Scholar
  6. 6.
    Lachmann B, Van Daal G-J (1992) Adult Respiratory Distress Syndrome: Animal Models. In: Robertson B, Van Golde LMG, Batenburg JJ (eds) Pulmonary Surfactant: from molecular biology to clinical practice. Elsevier Science Publishers BV, pp 635 - 663Google Scholar
  7. 7.
    Eijking EP, Gommers D, So KL et al (1993) Prevention of respiratory failure after hydrochloric acid aspiration by intratracheal surfactant instillation in rats [see comments]. Anesth Analg 76: 472 - 477PubMedCrossRefGoogle Scholar
  8. 8.
    Segerer H, van Gelder W, Angenent FW (1993) Pulmonary distribution and efficacy of exogenous surfactant in lung-lavaged rabbits are influenced by the instillation technique. Pediatr Res 34: 490 - 494PubMedCrossRefGoogle Scholar
  9. 9.
    Gilliard N, Richman PM, Merritt TA (1990) Effect of volume and dose on the pulmonary distribution of exogenous surfactant administered to normal rabbits or to rabbits with oleic acid lung injury. Am Rev Respir Dis 141: 743 - 747PubMedCrossRefGoogle Scholar
  10. 10.
    Lewis JF, Tabor B, Ikegami M et al (1993) Lung function and surfactant distribution in saline-lavaged sheep given instilled vs. nebulized surfactant. J Appl Physiol 74: 1256 - 1264PubMedCrossRefGoogle Scholar
  11. 11.
    Gommers D, Eijking EP, So KL et al (1998) Bronchoalveolar lavage with a diluted surfactant suspension prior to surfactant instillation improves the effectiveness of surfactant therapy in experimental acute respiratory distress syndrome ( ARDS ). Intensive Care Med 24: 494-500Google Scholar
  12. 12.
    Gommers D, van't Veen A, Verbrugge SJC et al (1998) Comparison of eight different surfactant preparations on improvement of blood gases in lung-lavaged rats. Appl Cardiopulm Pathophysiol 7: 95 - 102Google Scholar
  13. 13.
    Gommers D, Lachmann B (1993) Surfactant therapy: does it have a role in adults? Clin Intensive Care 4: 284 - 295Google Scholar
  14. 14.
    Walmrath D, Gunther A, Ghofrani HA et al (1996) Bronchoscopie surfactant administration in patients with severe adult respiratory distress syndrome and sepsis. Am J Respir Crit Care Med 154: 57 - 62PubMedGoogle Scholar
  15. 15.
    Gregory TJ, Steinberg KP, Spragg R et al (1997) Bovine surfactant therapy for patients with acute respiratory distress syndrome. Am J Respir Crit Care Med 155: 1309 - 1315PubMedGoogle Scholar
  16. 16.
    Anzueto A, Baughman RP, Guntupalli KK et al (1996) Aerosolized surfactant in adults with sepsis-induced acute respiratory distress syndrome. N Engl J Med 334: 1417 - 1421PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2000

Authors and Affiliations

  • J. J. Haitsma
  • B. Lachmann

There are no affiliations available

Personalised recommendations