Fraisse A, Paut O, Silicani M A, Viard L, Camboulives J
Département d'anesthésie-réanimation pédiatrique, hôpital de La Timone, Marseille, France.
Arch Pediatr. 1996 Sep;3(9):891-5. doi: 10.1016/0929-693x(96)87581-6.
Adult respiratory distress syndrome has a high mortality rate, despite treatment including mechanical ventilation with positive end-expiratory pressure, increase of the inspiratory time and high inspiratory oxygen concentration. Exogenous surfactant, a well established treatment in premature newborns with neonatal respiratory distress syndrome has only been occasionally evaluated in adult respiratory distress syndrome.
A 3 year-old child suffered from adult respiratory distress secondary to respiratory syncytial virus infection. Both mechanical ventilation and inhaled nitric oxide failed to improve the respiratory distress. Two doses of intratracheal surfactant application immediately improved pulmonary functions, transiently after the first instillation on day 13 and definitely after the second one, on day 16.
Exogenous surfactant appeared to be useful for the survival of our patient but prospective evaluation of this treatment in adult respiratory distress syndrome is needed.
尽管采用了包括呼气末正压通气、延长吸气时间和高吸入氧浓度等机械通气治疗，成人呼吸窘迫综合征的死亡率仍很高。外源性表面活性物质是治疗新生儿呼吸窘迫综合征的成熟方法，但在成人呼吸窘迫综合征中仅偶尔进行评估。
一名3岁儿童因呼吸道合胞病毒感染继发成人呼吸窘迫。机械通气和吸入一氧化氮均未能改善呼吸窘迫。气管内应用两剂表面活性物质后，肺功能立即得到改善，第13天首次滴注后短暂改善，第16天第二次滴注后明显改善。
外源性表面活性物质似乎有助于我们这位患者的存活，但需要对该治疗方法在成人呼吸窘迫综合征中的应用进行前瞻性评估。
