SURFACTANT REPLACEMENT THERAPY IN LATE-STAGE ADULT-RESPIRATORY-DISTRESS-SYNDROME

In four adult patients with late-stage acute respiratory distress synd rome (ARDS), a single dose of the artificial surfactant ALEC was given by intrabronchial instillation. There was no sustained clinical impro vement, but bronchoalveolar lavage measurements indicated that phospha tidylcholine (PC) at 24 h after treatment had increased up to 4.4 fold and phosphatidylglycerol up to 34.7 fold. However, PC relative to tot al phospholipid remained below normal, and protein contamination relat ive to PC remained above normal. Thus, therapeutic formulations and re gimens to achieve greater and more sustained supplementation of PC may be required in patients with late-stage ARDS.