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| |  Surfaxin Shows Promise In Acute Respiratory Distress Syndrome NEW YORK, N.Y. -- November 1, 1999 -- Cleansing of the lungs with dilute synthetic pulmonary surfactant may offer a new, safe and feasible approach to improve the outcome of acute respiratory distress syndrome (ARDS) patients, according to new research. The study appears in the October issue of the American Journal of Respiratory and Critical Care Medicine.
A life-threatening type of lung failure, ARDS results from injuries or illnesses that cause fluid accumulation in the lung. It usually develops 12 to 24 hours after a specific clinical problem. The syndrome causes serious oxygen deprivation, with a fatality rate running as high as 40 to 60 percent. ARDS can be caused by direct lung injury from pneumonia, near drowning, toxic gas inhalation, chest/lung trauma, or aspiration of gastric contents. It can be associated with severe widespread infection (sepsis), non-thoracic trauma, major surgery, multiple blood transfusions, or other systemic problems. Although there is no current accepted treatment for ARDS, these investigators recognized that surfactant dysfunction was a major component in the pathophysiology of the illness. At five academic teaching hospitals in the U.S., they enrolled 12 ARDS patients in intensive care units over a five-month period to assess the safety and tolerability of sequential bronchopulmonary segmental lavage with a dilute synthetic surfactant (Surfaxin). The subjects were assigned to one of three treatment regimens with escalating doses of the artificial compound. All patients completed the treatment phases. The researchers placed the material, using a bronchoscope, in each of the 19 bronchopulmonary segments and suctioned within 10 to 30 seconds. All 12 patients were able to tolerate the process. Although there were no serious adverse consequences from the procedure, according to the investigators, three of the five ARDS patients with sepsis died. The seven non-sepsis ARDS patients were off mechanical ventilation for an average of slightly over 20 days, and all had been discharged by day 28. The two surviving ARDS patients with sepsis were off mechanical ventilation for an average of 2.8 days by day 28, when neither had been discharged. The investigators believe this study provides the first attempt to cleanse the lungs of ARDS patients in order to provide sufficient functional surfactant to assist in gas exchange. After instillation, patients showed improved oxygenation and required lower ventilator settings. The researchers believe their approach may mitigate the fundamental mechanisms of early ARDS and provide a rational basis for treating affected patients.
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