Instillation of calf lung surfactant extract (calfactant) is beneficial in pediatric acute hypoxemic respiratory failure. Members of the Mid-Atlantic Pediatric Critical Care Network.
Instillation of calf lung surfactant extract (calfactant) is beneficial in pediatric acute hypoxemic respiratory failure. Members of the Mid-Atlantic Pediatric Critical Care Network.
复制标题
滴注小牛肺表面活性剂提取物（calfactant）对于小儿急性低氧性呼吸衰竭有益。
作者：
D. Willson;A. Zaritsky;L. Bauman;Keith Dockery;R. James;Debra Conrad;Hugh Craft;W. Novotny;E. Egan;H. Dalton
客观化
小牛肺表面活性物质提取物治疗儿童呼吸衰竭的前瞻性研究。
设计
多机构、前瞻性、随机、对照、非盲法试验。
设置
三级医疗中心8个儿科重症监护病房(ICU)。
病人
42例儿童急性低氧性呼吸衰竭，以弥漫性双侧肺浸润性病变为特征，需要呼吸机支持，氧合指数为>；7。
干预
气管内滴注表面活性物质(80毫升/平方米)。
测量方法和主要结果
记录使用肺表面活性物质前后的呼吸机参数、动脉血气、氧合指数和换气指数。并发症和结果指标，包括死亡率、机械通气时间、儿科ICU和住院时间也被检查。与对照组相比，接受表面活性物质治疗的患者氧合状况迅速改善，拔管时间平均提前4.2天(32%)，儿科重症监护时间减少5天(30%)。在死亡率或总住院时间方面没有差异。表面活性物质的使用与没有严重的不良反应有关。
结论
小牛肺表面活性物质提取物是一种降钙剂，它的应用似乎是安全的，并与急性低氧性呼吸衰竭患儿的氧合迅速改善、更早拔管以及减少重症监护需求有关。然而，在推荐在儿科呼吸衰竭中广泛使用之前，还需要进一步的研究。
OBJECTIVE
Prospective study of the efficacy of calf lung surfactant extract in pediatric respiratory failure.
DESIGN
Multi-institutional, prospective, randomized, controlled, unblinded trial.
SETTING
Eight pediatric intensive care units (ICU) of tertiary medical centers.
PATIENTS
Forty-two children with acute hypoxemic respiratory failure characterized by diffuse, bilateral pulmonary infiltrates, need for ventilatory support, and an oxygenation index of >7.
INTERVENTION
Instillation of intratracheal surfactant (80 mL/m2).
MEASUREMENTS AND MAIN RESULTS
Ventilator parameters, arterial blood gases, and derived oxygenation and ventilation indices were recorded before and at intervals after surfactant administration. Complications and outcome measures, including mortality, duration of mechanical ventilation, and length of pediatric ICU and hospital stay, were also examined. Patients who received surfactant demonstrated rapid improvement in oxygenation and, on average, were extubated 4.2 days (32%) sooner and spent 5 fewer days (30%) in pediatric intensive care than control patients. There was no difference in mortality or overall hospital stay. Surfactant administration was associated with no serious adverse effects.
CONCLUSIONS
Administration of calf lung surfactant extract, calfactant, appears to be safe and is associated with rapid improvement in oxygenation, earlier extubation, and decreased requirement for intensive care in children with acute hypoxemic respiratory failure. Further study is needed, however, before widespread use in pediatric respiratory failure can be recommended.
用人类表面活性剂预防性治疗极早产儿。
DOI：
10.1056/nejm198609253151301
发表时间：
1986
期刊：
The New England journal of medicine
影响因子：
--
作者：
Merritt,TA;Hallman,M;Bloom,BT;Berry,C;Benirschke,K;Sahn,D;Key,T;Edwards,D;Jarvenpaa,AL;Pohjavuori,M
通讯作者：
Pohjavuori,M
DOI：
10.1164/ajrccm.155.4.9105072
发表时间：
1997-04-01
影响因子：
24.7
作者：
Gregory, TJ;Steinberg, KP;Gold, AJ
通讯作者：
Gold, AJ