Effect of surfactant on respiratory failure associated with thoracic aneurysm surgery.
OBJECTIVE
To study the effects of surfactant administration on the left lung after surgical repair of descending aortic aneurysms on postoperative respiratory failure.


METHODS
Randomized, prospective, controlled study.


METHODS
Clinical investigation.


METHODS
Eleven patients with respiratory failure associated with thoracic aneurysm surgery.


METHODS
Eleven adult patients with acute respiratory failure (PaO2/FIO2 <300 torr [<40 kPa]) after surgical repair of descending aortic aneurysms. The artificial surfactant (30 mg/kg) was given to the operated side of the lung by intrabronchial instillation in six patients (surfactant group), whereas nothing was instilled in the other five patients (control group).


RESULTS
Hemodynamic parameters, blood gas, and peak inspiratory pressure were measured at the end of surgery, before surfactant instillation, and at 2, 6, 12, 24, and 48 hrs after surfactant instillation. At the end of surgery, the mean +/- SEM values of the PaO2/FIO2 ratio were 204 +/- 25 torr (27.2 +/- 3.3 kPa) in the surfactant group and 240 +/- 26 torr (32.0 +/- 3.5 kPa) in the control group. After 2, 6, 12, and 48 hrs, improvements in the PaO2/FIO2 ratios were observed in the surfactant group, whereas the control group showed no improvement. Two hours after surfactant instillation, the mean value in the PaO2/FIO2 ratio was significantly higher in the surfactant group (318 +/- 24 torr [42.4 +/- 3.2 kPa]) (p < .05) compared with the control group values (240 +/- 34 torr [32 +/- 4.5 kPa]).


CONCLUSIONS
Surfactant administration immediately after surgery restored gas exchange in postoperative respiratory failure associated with thoracic aneurysm surgery.
Department of Anesthesiology, Tohoku University School of Medicine, Sendai, Japan.
D
D
Satoh
S
S
Matsukawa
T
T
Saishu
Y
Y
Hashimoto
D000208:Acute Disease; D000368:Aged; D000403:Airway Resistance / Q000187:drug effects; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001784:Blood Gas Analysis; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007322:Instillation, Drug; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy* / Q000209:etiology; D011446:Prospective Studies; D011663:Pulmonary Surfactants / Q000627:therapeutic use*; D012128:Respiratory Distress Syndrome / Q000188:drug therapy* / Q000209:etiology; D012131:Respiratory Insufficiency / Q000188:drug therapy* / Q000209:etiology
D011663:Pulmonary Surfactants