ADULT-RESPIRATORY-DISTRESS-SYNDROME AND ARTIFICIAL SURFACTANT REPLACEMENT IN THE PEDIATRIC-PATIENT

Adult respiratory distress syndrome (ARDS) frequently develops after n ear-drowning, smoke inhalation, burns, blunt trauma to chest, and over whelming sepsis, Surfactant depletion, inactivation or destruction by the accumulation of proteinaceous material in the alveoli, and changes in the relative composition of phospholipids or protein component hav e been associated with ARDS, Artificial surfactant reverses these chan ges in experimental animals, Seven cases of ARDS have been treated on an experimental basis with artificial surfactant after approval and in accordance with ethical standards of the institution's committee on h uman experimentation. Informed consent was obtained from parents prior to administering artificial surfactant, We identified five cases of A RDS in retrospective analysis and used them as historical controls, Mo rtality between these two groups was analyzed with Fisher's exact test , One of seven (14.2%) children treated with surfactant died of overwh elming infection, and 2/5 (40%) of the historical controls died of pul monary causes (P = 0.523), Statistically, surfactant therapy did not i mprove survival in patients with ARDS; however, ARDS patients receivin g surfactant improved in their pulmonary dynamic compliance and had a tendency to stabilize earlier in gas exchange, allowing us to decrease ventilatory support.