Acute side effects of surfactant treatment

Hentschel, Roland; Jorch, Gerhard

doi:10.1515/jpm.2002.018

Cited by 22 publications

(13 citation statements)

References 39 publications

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“…13,14 However, bolus administration has also been associated with airway obstruction 15 and all infants in our study received surfactant using this technique. Wheeler et al 16 used assisted control volume guarantee ventilation during the administration of a surfactant with a volume of 1.25 ml kg À1 (Curosurf, Chiesi Farmaceutici SpA, Parma, Italy).…”

Section: Discussionmentioning

confidence: 94%

Severe airway obstruction during surfactant administration using a standardized protocol: a prospective, observational study

Tarawneh

Kaczmarek

et al. 2011

J Perinatol

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Objective: The objective of this study was to evaluate the occurrence of adverse effects during surfactant delivery, using a standardized protocol for administration and management of complications.Study Design: The protocol was developed, implemented and used for 6 months. Vital signs and ventilatory parameters were prospectively recorded during the procedure. Infants were classified into three groups, based on the occurrence and severity of complications: no, minor or major.Result: A total of 39 infants received surfactant and 19 presented some complication: 11 minor and 8 major. Six of the major complications were episodes of severe airway obstruction (SAO) and five occurred in extreme low birth weight (ELBW) infants that had more severe lung disease before surfactant delivery. Two cases of persistent pulmonary hypertension occurred in infants with birth weight>1000 g. Conclusion:This study identified a high rate of SAO and provides data to support changes in the protocol, which should include faster and more robust increases in positive inspiratory pressures in ELBW infants presenting with SAO.

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Section: Discussionmentioning

confidence: 94%

Severe airway obstruction during surfactant administration using a standardized protocol: a prospective, observational study

Tarawneh

Kaczmarek

et al. 2011

J Perinatol

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“…In some animals and newborns with RDS, administration of surfactant bolus led to decrease of systemic vascular resistance compensated by an increase in cardiac output, while pulmonary vascular resistance was either increased or decreased by activation of NO synthase [82]. Changes of arterial blood pressure after surfactant administration may result in changes of cerebral blood flow velocity and abnormalities of EEG [82]. Bolus administration can lead to an obstruction of tube or tracheobronchial tree or to a drug reflux with subsequent distention of terminal airways, pulmonary interstitial emphysema or pneumothorax [83].…”

Section: Exogenous Surfactantmentioning

confidence: 99%

Inflammation in Meconium Aspiration Syndrome: Targets for Pharmacological Modulation

Mokrá¹,

Mokrý

2007

CPR

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Pathophysiology of meconium aspiration syndrome (MAS) is complex and interactions between individual pathomechanisms are still not completely understood. As recently shown, inflammation plays a significant role in the pathogenesis of MAS. Activated cells release and stimulate production of a wide variety of mediators, including cytokines, enzymes, reactive species, and other biologically active substances in meconium-injured lungs. Anti-inflammatory drugs acting on different levels of inflammatory cascade may in combination with other treatment (exogenous surfactant, inhaled NO, liquid ventilation) improve the clinical status of newborns with MAS. For example, corticosteroids modulate activity of phospholipase A 2 and induced NO synthase, influence migration and activation of leukocytes, and reduce lung edema. Cyclooxygenase inhibitors modulate production of thromboxane and prostaglandins. Phosphodiesterase inhibitors have vasodilating, bronchodilating and anti-inflammatory effects. Antioxidants diminish formation of reactive species. However, there are many other drugs., e.g. anti-cytokine antibodies, inhibitors of complement, inhibitors of angiotensinconverting enzyme, anticoagulants, inhibitors of proteolytic enzymes, calcium-channel blockers etc. that may be beneficial in MAS. Nevertheless, further testing is necessary until the novel approaches may be recommended. In this article, authors reviewed main factors participating in meconium-induced inflammation and pointed out some targets for its pharmacological modulation.

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“…Due to high cost and concern for its dangerous acute side effects, such as intense instant hemodynamic fluctuation and hypoxemia [9], physicians are usually cautious in PS dosage. It has been suspected that the single-dose scheme may be enough to revive the intrinsic production, as exogenous surfactant can be recycled by the host type II epithelial cells.…”

Section: Introductionmentioning

confidence: 99%

Beneficial effect of exogenous surfactant in infants suffering acute respiratory distress syndrome after cardiac surgery

Cai

Zhou

et al. 2011

European Journal of Cardio-Thoracic Surgery

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Acute side effects of surfactant treatment

Cited by 22 publications

References 39 publications

Severe airway obstruction during surfactant administration using a standardized protocol: a prospective, observational study

Severe airway obstruction during surfactant administration using a standardized protocol: a prospective, observational study

Inflammation in Meconium Aspiration Syndrome: Targets for Pharmacological Modulation

Beneficial effect of exogenous surfactant in infants suffering acute respiratory distress syndrome after cardiac surgery

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