title: Surfactant treatment for congenital heart disease patients with acute respiratory distress syndrome.
abstract: Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) can be a significant source of morbidity for pediatric cardiac patients in the intensive care unit. Children with unrepaired or palliated congenital heart disease are at increased risk for lower respiratory tract infections, while postoperatively they are at risk for ALI/ARDS precipitated by cardiopulmonary bypass. Surfactant dysfunction and inactivation are key contributors to the pathophysiology of ALI/ARDS, and there is growing evidence that exogenous intratracheal surfactant administration in noncardiac patients may ameliorate the lung injury seen in children with ALI/ARDS, leading to improved outcomes and survival. Evidence for a beneficial effect of exogenous surfactant treatment in congenital heart disease patients with ALI/ARDS is lacking. We present three consecutive children with congenital heart disease and ARDS who had significant and sustained improvement in lung function and oxygenation after treatment with exogenous surfactant, hastening their recovery from life-threatening hypoxemia.
authors.affiliation: Department of Pediatrics, Division of Critical Care, The University of Alabama, Birmingham, Ala 35233, USA. jalten@peds.uab.edu
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Alten
authors.forename: Santiago
authors.initials: S
authors.lastname: Borasino
authors.forename: Frank B
authors.initials: FB
authors.lastname: Pearce
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Dabal
authors.forename: James K
authors.initials: JK
authors.lastname: Kirklin
mesh_terms: D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000601:surgery*; D006801:Humans; D000860:Hypoxia / Q000188:drug therapy* / Q000209:etiology; D007223:Infant; D008168:Lung / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D011663:Pulmonary Surfactants / Q000627:therapeutic use*; D020127:Recovery of Function; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D016896:Treatment Outcome; D015300:Ventilator Weaning
chemical_list: D011663:Pulmonary Surfactants