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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Surfactant therapy and extracorporeal life support. | Available online http ccforum.eom content 10 1 401 Letter Surfactant therapy and extracorporeal life support Frans B Plotz Pediatric Intensivist VU Medical Center Department of Pediatric Intensive Care Amsterdam The Netherlands Corresponding author Frans B Plotz fb.plotz@vumc.nl Published 8 December 2005 This article is online at http ccforum.com content 10 1 401 2005 BioMed Central Ltd Critical Care 2006 10 401 doi 10.1186 cc3933 See related research by Hermon et al. in issue 9.6 http ccforum content 9 6 R718 I read with great interest the article by Hermon and coworkers 1 who reported that surfactant application in children with severe respiratory failure treated with extracorporeal membrane oxygenation was associated with improved lung volume and pulmonary mechanics. Although these findings must be confirmed in prospective studies they are very promising. Based on a series of animal studies more than 10 years ago we advocated use of a combination of surfactant therapy and extracorporeal life support in the treatment of severe respiratory failure. We found that one effective option is to combine intratracheal instillation of a large fluid volume with diluted surfactant and LFV-ECCO2R low frequency ventilation and extracorporeal carbon dioxide removal . In animal studies using 141Ce-labelled microspheres mixed with the surfactant 2 3 we observed that following endotracheal administration this surfactant preparation was distributed inhomogeneously in the lungs. However significantly improved distribution was achieved when this dose of surfactant 100 mg kg body weight was diluted with normal saline to a concentration of 6.25 g l. In order to apply this dose intratracheal fluid administration of 16.0 ml kg body weight was required. Subsequently we evaluated the effect of large volume fluid installation in lung lavaged rabbits while applying two gas exchange techniques namely continuous positive pressure ventilation and LFV-ECCO2R 4 . We observed significantly higher
