tetano
Editor, Senior Moderator
Respir Med
. 2021 May 29;185:106489.
doi: 10.1016/j.rmed.2021.106489. Online ahead of print.
Beneficial effects of inhaled surfactant in patients with COVID-19-associated acute respiratory distress syndrome
Sergey N Avdeev[SUP] 1 [/SUP], Natalia V Trushenko[SUP] 2 [/SUP], Svetlana Yu Chikina[SUP] 2 [/SUP], Natalia A Tsareva[SUP] 2 [/SUP], Zamira M Merzhoeva[SUP] 2 [/SUP], Andrey I Yaroshetskiy[SUP] 2 [/SUP], Violetta I Sopova[SUP] 3 [/SUP], Margarita I Sopova[SUP] 3 [/SUP], Oleg A Rosenberg[SUP] 4 [/SUP], Ralph Theo Schermuly[SUP] 5 [/SUP], Djuro Kosanovic[SUP] 2 [/SUP]
Affiliations
Abstract
Background: We have investigated the use of nebulized surfactant as a potential therapeutic option for the patients with coronavirus disease 2019 (COVID-19)-associated acute respiratory distress syndrome (ARDS) undergoing non-invasive ventilation.
Methods: The patients were divided into 2 groups: surfactant (n = 33) and control (n = 32). The subjects in the surfactant group received the inhaled surfactant at daily dose of 150-300 mg. The oxygenation parameters and several clinical outcomes were analyzed.
Results: On the 5 day of therapy, PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] improved significantly in the surfactant group compared to the control group (184 (155-212) mmHg vs 150 (91-173) mmHg, p = 0.02). The inhaled surfactant significantly reduced the need for transfer of patients to intensive care units (24.2% vs 46.9%, p = 0.05) and invasive mechanical ventilation (18.2% vs 40.6%, p = 0.04). Even more, the nebulized surfactant shortened the length of non-invasive ventilation (7 (3-13) days vs 11 (5-22) days, p = 0.02) and time spent in hospital (18 (16-27) days vs 26 (21-31) days, p = 0.003) in patients suffering from COVID-19-linked ARDS.
Conclusions: Our preliminary data provided indications that inhaled surfactant therapy may represent a promising option for patients with COVID-19-associated ARDS. However, larger clinical trials are crucially needed.
Keywords: Acute respiratory distress syndrome; COVID-19; Inhalation; Surfactant.
. 2021 May 29;185:106489.
doi: 10.1016/j.rmed.2021.106489. Online ahead of print.
Beneficial effects of inhaled surfactant in patients with COVID-19-associated acute respiratory distress syndrome
Sergey N Avdeev[SUP] 1 [/SUP], Natalia V Trushenko[SUP] 2 [/SUP], Svetlana Yu Chikina[SUP] 2 [/SUP], Natalia A Tsareva[SUP] 2 [/SUP], Zamira M Merzhoeva[SUP] 2 [/SUP], Andrey I Yaroshetskiy[SUP] 2 [/SUP], Violetta I Sopova[SUP] 3 [/SUP], Margarita I Sopova[SUP] 3 [/SUP], Oleg A Rosenberg[SUP] 4 [/SUP], Ralph Theo Schermuly[SUP] 5 [/SUP], Djuro Kosanovic[SUP] 2 [/SUP]
Affiliations
- PMID: 34087610
- DOI: 10.1016/j.rmed.2021.106489
Abstract
Background: We have investigated the use of nebulized surfactant as a potential therapeutic option for the patients with coronavirus disease 2019 (COVID-19)-associated acute respiratory distress syndrome (ARDS) undergoing non-invasive ventilation.
Methods: The patients were divided into 2 groups: surfactant (n = 33) and control (n = 32). The subjects in the surfactant group received the inhaled surfactant at daily dose of 150-300 mg. The oxygenation parameters and several clinical outcomes were analyzed.
Results: On the 5 day of therapy, PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] improved significantly in the surfactant group compared to the control group (184 (155-212) mmHg vs 150 (91-173) mmHg, p = 0.02). The inhaled surfactant significantly reduced the need for transfer of patients to intensive care units (24.2% vs 46.9%, p = 0.05) and invasive mechanical ventilation (18.2% vs 40.6%, p = 0.04). Even more, the nebulized surfactant shortened the length of non-invasive ventilation (7 (3-13) days vs 11 (5-22) days, p = 0.02) and time spent in hospital (18 (16-27) days vs 26 (21-31) days, p = 0.003) in patients suffering from COVID-19-linked ARDS.
Conclusions: Our preliminary data provided indications that inhaled surfactant therapy may represent a promising option for patients with COVID-19-associated ARDS. However, larger clinical trials are crucially needed.
Keywords: Acute respiratory distress syndrome; COVID-19; Inhalation; Surfactant.