Document Detail


Porcine-derived surfactant treatment of severe bronchiolitis.
MedLine Citation:
PMID:  9698957     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: It is hypothesized that surfactant treatment helps to improve severe bronchiolitis by restoring surfactant system activity. This study aims to assess the effect of surfactant on gas exchange, peak inspiratory pressure and duration of mechanical ventilation and intensive care unit (ICU) stay in children with severe bronchiolitis. METHODS: Twenty children with bronchiolitis requiring mechanical ventilation were randomly assigned to one of two groups (10 patients each). Group A was treated with continuous positive pressure ventilation (CPPV) plus surfactant. Group B was treated with CPPV only. Porcine-derived surfactant, 50 mg/kg body weight, was instilled into the trachea. Arterial tension of oxygen/fraction of inspired oxygen (PaO2/FiO2) ratio, arterial tension of carbon dioxide (PaCO2), and peak inspiratory pressure (PIP) were assessed. Heart rate and non-invasive arterial blood pressure were monitored. The duration of CPPV and the length of ICU stay were also recorded. Finally, the incidence of complications and the survival rate were assessed. RESULTS: In group A, the PaO2/FiO2 ratio significantly improved from 1 h and a reduction in PaCO2 was noted from 12 h. A reduction of PIP was observed from 3 h. The duration of CPPV and the length of ICU stay were reduced in group A. No complications were reported in either group and all children survived. CONCLUSIONS: Surfactant treatment of severe bronchiolitis appeared to improve gas exchange, reduce PIP and shorten CPPV and ICU stay. However, these initial results must be confirmed by a larger and more rigorously controlled study.
Authors:
M Luchetti; G Casiraghi; R Valsecchi; E Galassini; G Marraro
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  42     ISSN:  0001-5172     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  1998 Aug 
Date Detail:
Created Date:  1998-10-13     Completed Date:  1998-10-13     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  805-10     Citation Subset:  IM    
Affiliation:
Department of Anaesthesia and Intensive Care, Fatebenefratelli and Ophthalmiatric Hospital, Milano, Italy.
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Animals
Blood Pressure / drug effects
Bronchiolitis / drug therapy*
Carbon Dioxide / blood
Child, Preschool
Female
Heart Rate / drug effects
Humans
Incidence
Infant
Infant, Newborn
Inhalation / drug effects
Intensive Care
Length of Stay
Male
Oxygen / blood
Positive-Pressure Respiration
Pressure
Pulmonary Gas Exchange / drug effects
Pulmonary Surfactants / administration & dosage,  adverse effects,  therapeutic use*
Pulmonary Ventilation / drug effects
Respiration, Artificial
Survival Rate
Swine
Chemical
Reg. No./Substance:
0/Pulmonary Surfactants; 124-38-9/Carbon Dioxide; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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