Harms K, Herting E
Department of Pediatrics, University of Göttingen, Germany.
Respiration. 1994;61(6):348-52. doi: 10.1159/000196367.
We report two cases of adult respiratory distress syndrome (ARDS) treated successfully with repeated doses of a bovine natural surfactant (Survanta). Two former premature infants developed severe respiratory failure as a consequence of a chlamydial pneumonia at the age of 3 or 12 weeks, respectively. As both patients were threatened by hypoxia in spite of mechanical ventilation with maximal pressures using 100% O2 and as the X-rays were compatible with the diagnosis of ARDS, we decided to perform rescue surfactant treatment. Following surfactant instillation, marked improvement in oxygenation and ventilatory requirements was observed. Within 2 h after surfactant replacement, the PaO2/FiO2 ratio increased from 52 to 84 (case 1) and from 35 to 94 (case 2), and the peak inspiratory pressure could be reduced from 47 to 40 cm H2O and from 35 to 28 cm H2O, respectively. Both infants received a second surfactant dose about 10 h after the initial treatment and survived without developing chronic lung disease.
我们报告了两例成人呼吸窘迫综合征（ARDS）患者，使用重复剂量的牛天然表面活性剂（固尔苏）成功治愈。两名曾为早产儿，分别在3周或12周龄时因衣原体肺炎而出现严重呼吸衰竭。尽管使用100%氧气并以最大压力进行机械通气，两名患者仍面临缺氧威胁，且X线检查结果符合ARDS诊断，因此我们决定进行抢救性表面活性剂治疗。注入表面活性剂后，观察到氧合和通气需求显著改善。在更换表面活性剂后2小时内，病例1的动脉血氧分压/吸入氧分数值（PaO2/FiO2）从52升至84，病例2从35升至94，同时吸气峰压分别从47厘米水柱降至40厘米水柱以及从35厘米水柱降至28厘米水柱。两名婴儿在初始治疗约10小时后均接受了第二次表面活性剂剂量治疗，并存活下来，未发生慢性肺部疾病。
