Bronchopulmonary segmental lavage with surfaxin (KL4-surfactant) for acute respiratory distress syndrome

Thomas E. Wiswell, Robert M. Smith, Laurence B. Katz, Lisa Mastroianni, Davies Y. Wong, David Willms, Stephen Heard, Mark Wilson, R. Duncan Hite, Antonio Anzueto, Susan D. Revak, Charles G. Cochrane

Research output: Contribution to journalArticlepeer-review

117 Scopus citations

Abstract

We performed a trial to assess the safety and tolerability of sequential bronchopulmonary segmental lavage with a dilute synthetic surfactant (Surfaxin) in 12 adults with ARDS. Patients received one of three dosing regimens in which aliquots of Surfaxin were administered via a wedged bronchoscope to each of the 19 bronchopulmonary segments. Suctioning was performed 10-30 s after instillation of individual aliquots. Group 1 patients (n = 3) received one 30-ml aliquot of a 2.5-mg/ml concentration of Surfaxin in each segment, followed by a second 30-ml aliquot with a 10-mg/ml concentration. Group 2 patients (n = 4) received two 30-ml aliquots of the 2.5-mg/ml concentration followed by a third lavage with the 10-mg/ml concentration. Group 3 patients (n = 5) received therapy identical to that received by patients in Group 2 and were eligible for repeat dosing 6 to 24 h later. All patients tolerated the procedure. There were no serious adverse experiences ascribed to either the procedure or the surfactant. In the 96 h after treatment initiation, Fl(o2) decreased from 0.80 to 0.52 and PEEP decreased from 10.3 to 7.6 cm H2O. Bronchoscopic 'cleansing' of the lungs with dilute Surfaxin may offer a safe and feasible approach to improving outcomes in patients with ARDS.

Original languageEnglish (US)
Pages (from-to)1188-1195
Number of pages8
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume160
Issue number4
DOIs
StatePublished - 1999

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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