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See 1 citation in N Engl J Med 2004:

N Engl J Med. 2004 Aug 26;351(9):884-92.

Effect of recombinant surfactant protein C-based surfactant on the acute respiratory distress syndrome.

Author information

1
University of California at San Diego, Veterans Affairs Medical Center, San Diego 92014, USA. rspragg@ucsd.edu

Abstract

BACKGROUND:

Preclinical studies suggest that exogenous surfactant may be of value in the treatment of the acute respiratory distress syndrome (ARDS), and two phase 2 clinical trials have shown a trend toward benefit. We conducted two phase 3 studies of a protein-containing surfactant in adults with ARDS.

METHODS:

In two multicenter, randomized, double-blind trials involving 448 patients with ARDS from various causes, we compared standard therapy alone with standard therapy plus up to four intratracheal doses of a recombinant surfactant protein C-based surfactant given within a period of 24 hours.

RESULTS:

The overall survival rate was 66 percent 28 days after treatment, and the median number of ventilator-free days was 0 (68 percent range, 0 to 26); there was no significant difference between the groups in terms of mortality or the need for mechanical ventilation. Patients receiving surfactant had a significantly greater improvement in blood oxygenation during the initial 24 hours of treatment than patients receiving standard therapy, according to both univariate and multivariate analyses.

CONCLUSIONS:

The use of exogenous surfactant in a heterogeneous population of patients with ARDS did not improve survival. Patients who received surfactant had a greater improvement in gas exchange during the 24-hour treatment period than patients who received standard therapy alone, suggesting the potential benefit of a longer treatment course.

PMID:
15329426
DOI:
10.1056/NEJMoa033181
[Indexed for MEDLINE]
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