López-Herce J, de Lucas N, Carrillo A, Bustinza A, Moral R
Pediatric Intensive Care Unit, Gregorio Marañon University General Hospital, Madrid, Spain.
Arch Dis Child. 1999 Mar;80(3):248-52. doi: 10.1136/adc.80.3.248.
To determine prospectively the efficacy of surfactant in acute respiratory distress syndrome.
Twenty patients, 1 month to 16 years of age, diagnosed with an acute pulmonary disease with severe hypoxaemia (PaO2/FiO2 < 100) (13 with systemic or pulmonary disease and seven with cardiac disease) were treated with one to six doses of 50-200 mg/kg of porcine surfactant administered directly into the trachea. The surfactant was considered to be effective when the PaO2/FiO2 improved by > 20%.
After initial surfactant administration the PaO2/FiO2 increased significantly in patients with systemic or pulmonary disease from 68 to 111, and the oxygenation index (OI) diminished significantly from 36.9 to 27.1. The PaO2/FiO2 and OI did not improve in children with cardiac disease. The improvement of the patients who survived was greater than that of those who died.
Surfactant moderately improves oxygenation in some children with severe acute respiratory distress syndrome secondary to pulmonary or systemic disease.
前瞻性地确定表面活性剂在急性呼吸窘迫综合征中的疗效。
20例年龄在1个月至16岁之间、诊断为伴有严重低氧血症（动脉血氧分压/吸入氧分数值<100）的急性肺部疾病患者（13例患有全身性或肺部疾病，7例患有心脏疾病）接受了1至6剂50 - 200mg/kg猪肺表面活性剂经气管直接给药治疗。当动脉血氧分压/吸入氧分数值改善>20%时，表面活性剂被认为有效。
首次给予表面活性剂后，患有全身性或肺部疾病的患者动脉血氧分压/吸入氧分数值从68显著升至111，氧合指数（OI）从36.9显著降至27.1。患有心脏疾病的儿童的动脉血氧分压/吸入氧分数值和氧合指数未得到改善。存活患者的改善情况大于死亡患者。
表面活性剂可适度改善一些继发于肺部或全身性疾病的严重急性呼吸窘迫综合征儿童的氧合情况。
