In:
Respiration, S. Karger AG, Vol. 69, No. 1 ( 2002), p. 57-62
Abstract:
〈 i 〉 Background: 〈 /i 〉 Surfactant abnormalities have been described in bacterial pneumonia. 〈 i 〉 Objective: 〈 /i 〉 To determine the safety and effect of exogenous surfactant replacement in patients with ventilator-associated pneumonia (VAP). 〈 i 〉 Methods: 〈 /i 〉 Patients with VAP were randomized in a double-blind study to receive either an artificial surfactant (Exosurf) consisting mostly of disaturated phospholipids (DSPL) or saline via a continuous nebulizer system for 5 days. Patients underwent bronchoscopy and bronchoalveolar lavage (BAL) prior to and after 4 days of therapy. 〈 i 〉 Results: 〈 /i 〉 Twenty-two patients were randomized, with 8 receiving Exosurf. There was no detected difference in outcome between the saline- and Exosurf-treated patients in terms of days on ventilator, 30-day or hospital mortality. At the follow-up lavage, the patients treated with Exosurf had a significant rise in the level of DSPL (p 〈 0.05), while the saline group did not, suggesting delivery of drug. Also at the follow-up lavage, the percentage of neutrophils in the BAL fell in the Exosurf patients (p 〈 0.01), but not in the saline group. 〈 i 〉 Conclusion: 〈 /i 〉 Exogenous surfactant replacement given to patients with VAP increased the amount of DSPL retrieved by BAL. This treatment was associated with a fall in the neutrophil response to pneumonia.
Type of Medium:
Online Resource
ISSN:
0025-7931
,
1423-0356
Language:
English
Publisher:
S. Karger AG
Publication Date:
2002
detail.hit.zdb_id:
1464419-8
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