tailieunhanh - Báo cáo y học: "Computed tomography assessment of exogenous surfactant-induced lung reaeration in patients with acute lung injur"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Computed tomography assessment of exogenous surfactant-induced lung reaeration in patients with acute lung injury. | Lu et al. Critical Care 2010 14 R135 http content 14 4 R135 c CRITICAL CARE RESEARCH Open Access Computed tomography assessment of exogenous surfactant-induced lung reaeration in patients with acute lung injury 1 2 z- I 3 1 4 1 Qin Lu Mao Zhang Cassio Girardi Belaid Bouhemad Jozef Kesecioglu Jean-Jacques Rouby 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 and a significant increase in volume of tissue in normally aerated lung areas 189 179 ml versus -15 105 ml in controls P . 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. .