Bronchopulmonary segmental lavage with surfaxin (KL4-surfactant) for acuterespiratory distress syndrome

We performed a trial to assess the safety and tolerability of sequential br onchopulmonary segmental lavage with a dilute synthetic surfactant (Surfaxi n) in 12 adults with ARDS. Patients received one of three dosing regimens i n which aliquots of Surfaxin were administered via a wedged bronchoscope to each of the 19 bronchopulmonary segments. Suctioning was performed 10-30 s after Instillation of individual aliquots. Group 1 patients (n = 3) receiv ed one 30-ml aliquot of a 2.5-mg/ml concentration of Surfaxin in each segme nt, followed by a second 30-ml aliquot with a 10-mg/ml concentration. Group 2 patients (n = 4) received two 30-ml aliquots of the 2.5-mg/ml concentrat ion followed by a third ravage with the 10-mg/ml concentration. Group 3 pat ients (n = 5) received therapy identical to that received by patients in Gr oup 2 and were eligible for repeat dosing 6 to 24 h later. All patients tol erated the procedure. There were no serious adverse experiences ascribed to either the procedure or the surfactant. In the 96 h after treatment initia tion, FIO2 decreased from 0.80 to 0.52 and PEEP decreased from 10.3 to 7.6 cm H2O. Bronchoscopic "cleansing" of the lungs with dilute Surfaxin may off er a safe and feasible approach to improving outcomes in patients with ARDS .