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Critical Care

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Open Access 01-08-2010 | Research

Computed tomography assessment of exogenous surfactant-induced lung reaeration in patients with acute lung injury

Authors: Qin Lu, Mao Zhang, Cassio Girardi, Belaïd Bouhemad, Jozef Kesecioglu, Jean-Jacques Rouby

Published in: Critical Care | Issue 4/2010

Abstract

Introduction

Previous randomized trials failed to demonstrate a decrease in mortality of patients with acute lung injury treated by exogenous surfactant. The aim of this prospective randomized study was to evaluate the effects of exogenous porcine-derived surfactant on pulmonary reaeration and lung tissue in patients with acute lung injury and acute respiratory distress syndrome (ALI/ARDS).

Methods

Twenty patients with ALI/ARDS were studied (10 treated by surfactant and 10 controls) in whom a spiral thoracic computed tomography scan was acquired before (baseline), 39 hours and 7 days after the first surfactant administration. In the surfactant group, 3 doses of porcine-derived lung surfactant (200 mg/kg/dose) were instilled in both lungs at 0, 12 and 36 hours. Each instillation was followed by recruitment maneuvers. Gas and tissue volumes were measured separately in poorly/nonaerated and normally aerated lung areas before and seven days after the first surfactant administration. Surfactant-induced lung reaeration was defined as an increase in gas volume in poorly/non-aerated lung areas between day seven and baseline compared to the control group.

Results

At day seven, surfactant induced a significant increase in volume of gas in poorly/non-aerated lung areas (320 ± 125 ml versus 135 ± 161 ml in controls, P = 0.01) and a significant increase in volume of tissue in normally aerated lung areas (189 ± 179 ml versus -15 ± 105 ml in controls, P < 0.01). PaO₂/FiO₂ ratio was not different between the surfactant treated group and control group after surfactant replacement.

Conclusions

Intratracheal surfactant replacement induces a significant and prolonged lung reaeration. It also induces a significant increase in lung tissue in normally aerated lung areas, whose mechanisms remain to be elucidated.

Trial registration

NCT00742482.

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Title: Computed tomography assessment of exogenous surfactant-induced lung reaeration in patients with acute lung injury
Authors: Qin Lu
Mao Zhang
Cassio Girardi
Belaïd Bouhemad
Jozef Kesecioglu
Jean-Jacques Rouby
Publication date: 01-08-2010
Publisher: BioMed Central
Published in: Critical Care / Issue 4/2010
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/cc9186

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Computed tomography assessment of exogenous surfactant-induced lung reaeration in patients with acute lung injury

Abstract

Introduction

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

Trial registration

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