Efficacy of pulmonary surfactant in the treatment of acute respiratory distress syndrome in young critical in5 fants after congenital heart disease operation / 中华实用儿科临床杂志

ABSTRACT

Objective To evaluate the efficacy of pulmonary surfactant(PS)in the treatment of acute respira﹣tory distress syndrome(ARDS)in the infants after congenital heart disease(CHD)operation. Methods The trial Was conducted from January 2012 to June 2017 in FuWai Hospital,and 90 infants Who had ARDS after cardiac surgery Were enrolled. They Were divided into 2 separate groups,PS group(conventional therapy +PS treatment,43 cases)and con﹣trol group(conventional therapy,47 cases). The clinical data,including age,body Weight,risk adjustment for congenital heart surgery 1(RACHS－1)degree,cardiopulmonary bypass( CPB)time,aortic occlusion time,mechanical ventila﹣tion time,intensive care unit(ICU)care time,mortality,complications,partial pressure of oxygen[pa(O2 )],fraction of inspiration O2(FiO2 )and pa(O2 )／FiO2(P／F),Were collected and analyzed. Results The average age,body Weight, RACHS－1 degree,CPB time and aortic occlusion time had no difference betWeen the 2 groups(P＞0. 05). After 24 h of treatment,pa(O2 )in PS group Was(94. 76 ± 13. 25)mmHg(1 mmHg﹦0. 133 kPa),Which Was significantly higher than that in control group[(67. 59 ± 7. 47)mmHg](P﹤0. 01). P／F in PS group Was 170. 37 ± 20. 62,Which Was sig﹣nificantly higher than that in control group(102. 65 ± 15. 29)( P﹤0. 01),While FiO2 in PS group Was(55. 18 ± 6. 89)%,Which Was significantly loWer than that in control group[(68. 59 ± 9. 59)%](P﹤0. 01). The mean me﹣chanical ventilation time[(194. 39 ± 26. 30)h]and ICU care time[(11. 64 ± 3. 26)d]of the experimental group Were shorter than control group[(288. 63 ± 26. 42)h and(16. 65 ± 4. 18)d],and the differences Were statistically significant(P﹤0. 01). Eight deaths occurred,PS group had 1 infant dead,and the control group had 7 deaths,so the mortality in PS group Was 2. 32%,loWer than that in control group(14. 89%),and the difference Was statistically sig﹣nificant(P﹤0. 01). Postoperative complications occurred in 23 patients,of Which PS group had 9 cases postoperative complications and control group had 15 cases,so the incidence of complications in PS group Was 20. 93%,loWer than that in control group(31. 91%),and the difference Was statistically significant(P ﹤0. 01). Conclusions PS has good efficacy in treating ARDS in infants With ARDS after congenital heart disease operation.