Document Detail


Successful use of surfactant to treat severe intrapulmonary hemorrhage after iatrogenic lung injury--A case report.
MedLine Citation:
PMID:  17006383     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To describe the beneficial clinical effect of the use of surfactant in a patient with severe unilateral pulmonary hemorrhage after iatrogenic lung injury during corrective surgery for congenital heart defects. DESIGN: Case report. SETTING: Pediatric cardiac intensive care unit of a tertiary care hospital. PATIENT: An 11-wk-old boy. INTERVENTIONS: Intratracheal instillation of 4 mL (100 mg) of surfactant (Survanta) per kilogram of body weight to treat profound and refractory hypoxia and hypercapnia despite high-ventilation pressures, high respiratory rate, and the use of nitric oxide caused by severe pulmonary hemorrhage and atelectasis. MEASUREMENTS AND MAIN RESULTS: The aggressive ventilation variables could be reduced within the following 2 hrs after surfactant use (from Fio2 0.8, peak inspiratory pressure 36 cm, positive end-expiratory pressure 10 cm, respiratory rate 50, tidal volume 63 mL, and nitric oxide 10 ppm to Fio2 0.4, peak inspiratory pressure 28 cm, positive end-expiratory pressure 10, respiratory rate 40, tidal volume 38 mL, and nitric oxide 5 ppm). There was rapid improvement of clinical variables (inotropic support, chest radiograph) as well as oxygenation (Pao2 from 56 to 149 mm Hg), CO2 exchange (Paco2 from 85 to 39 mm Hg), and acidosis (from pH 7.13 to 7.44). CONCLUSIONS: The administration of surfactant may be a promising approach to treat severe respiratory failure caused by severe pulmonary hemorrhage.
Authors:
Nikolaus A Haas; Karthikeyan Kulasekaran; Christoph K Camphausen
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies     Volume:  7     ISSN:  1529-7535     ISO Abbreviation:  Pediatr Crit Care Med     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-11-08     Completed Date:  2007-02-28     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  100954653     Medline TA:  Pediatr Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  583-5     Citation Subset:  IM    
Affiliation:
Department of Paediatric Cardiac Intensive Care, The Prince Charles Hospital, Brisbane, Australia.
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MeSH Terms
Descriptor/Qualifier:
Biological Products / therapeutic use*
Cardiopulmonary Bypass
Catheterization, Central Venous / adverse effects
Heart Defects, Congenital / surgery
Hemorrhage / drug therapy*,  etiology,  therapy
Humans
Iatrogenic Disease
Infant
Intensive Care Units, Pediatric
Intraoperative Complications / drug therapy*,  etiology,  therapy
Lung Injury*
Male
Pulmonary Atelectasis / drug therapy*,  etiology,  therapy
Pulmonary Surfactants / therapeutic use*
Respiratory Insufficiency / drug therapy*,  etiology
Chemical
Reg. No./Substance:
0/Biological Products; 0/Pulmonary Surfactants; 108778-82-1/beractant

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


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