Exogenous surfactant for lung contusion causing ARDS: A systematic review of clinical and experimental reports

IF 1.9 4区 医学 Q3 RESPIRATORY SYSTEM Clinical Respiratory Journal Pub Date : 2024-05-22 DOI:10.1111/crj.13776
Tomáš Merkl, David Astapenko, Radek Štichhauer, Antonín Šafus, Tomáš Dušek, Jiří Kotek, David Řehák, Petr Lochman
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Abstract

This systematic review aimed to summarize the available data on the treatment of pulmonary contusions with exogenous surfactants, determine whether this treatment benefits patients with severe pulmonary contusions, and evaluate the optimal type of surfactant, method of administration, and drug concentration. Three databases (MEDline, Scopus, and Web of Science) were searched using the following keywords: pulmonary surfactant, surface-active agents, exogenous surfactant, pulmonary contusion, and lung contusion for articles published between 1945 and February 2023, with no language restrictions. Four reviewers independently rated the studies for inclusion, and the other four reviewers resolved conflicts. Of the 100 articles screened, six articles were included in the review. Owing to the limited number of papers on this topic, various types of studies were included (two clinical studies, two experiments, and two case reports). In all the studies, surfactant administration improved the selected ventilation parameters. The most frequently used type of surfactant was Curosurf® in the concentration of 25 mg/kg of ideal body weight. In most studies, the administration of a surfactant by bronchoscopy into the segmental bronchi was the preferable way of administration. In both clinical studies, patients who received surfactants required shorter ventilation times. The administration of exogenous surfactants improved ventilatory parameters and, thus, reduced the need for less aggressive artificial lung ventilation and ventilation days. The animal-derived surfactant Curosurf® seems to be the most suitable substance; however, the ideal concentration remains unclear. The ideal route of administration involves a bronchoscope in the segmental bronchi.

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外源性表面活性物质治疗导致 ARDS 的肺挫伤:临床和实验报告的系统回顾。
本系统性综述旨在总结使用外源性表面活性物质治疗肺挫伤的现有数据,确定这种治疗方法是否对严重肺挫伤患者有益,并评估最佳的表面活性物质类型、给药方法和药物浓度。使用以下关键词在三个数据库(MEDline、Scopus 和 Web of Science)中检索了 1945 年至 2023 年 2 月间发表的文章:肺表面活性物质、表面活性剂、外源性表面活性物质、肺挫伤和肺挫伤,语言不限。四位审稿人对纳入的研究进行了独立评分,其他四位审稿人解决了冲突问题。在筛选出的 100 篇文章中,有 6 篇被纳入综述。由于该主题的论文数量有限,因此纳入了各种类型的研究(两项临床研究、两项实验和两项病例报告)。在所有研究中,表面活性物质的使用都改善了所选的通气参数。最常用的表面活性剂是 Curosurf®,浓度为 25 毫克/千克理想体重。在大多数研究中,通过支气管镜将表面活性物质注入节段性支气管是较好的给药方式。在两项临床研究中,接受表面活性物质治疗的患者所需的通气时间更短。外源性表面活性物质的应用改善了通气参数,从而减少了对低强度人工肺通气和通气天数的需求。动物源性表面活性物质 Curosurf® 似乎是最合适的物质,但理想的浓度仍不明确。理想的给药途径是在节段性支气管内使用支气管镜。
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来源期刊
Clinical Respiratory Journal
Clinical Respiratory Journal 医学-呼吸系统
CiteScore
3.70
自引率
0.00%
发文量
104
审稿时长
>12 weeks
期刊介绍: Overview Effective with the 2016 volume, this journal will be published in an online-only format. Aims and Scope The Clinical Respiratory Journal (CRJ) provides a forum for clinical research in all areas of respiratory medicine from clinical lung disease to basic research relevant to the clinic. We publish original research, review articles, case studies, editorials and book reviews in all areas of clinical lung disease including: Asthma Allergy COPD Non-invasive ventilation Sleep related breathing disorders Interstitial lung diseases Lung cancer Clinical genetics Rhinitis Airway and lung infection Epidemiology Pediatrics CRJ provides a fast-track service for selected Phase II and Phase III trial studies. Keywords Clinical Respiratory Journal, respiratory, pulmonary, medicine, clinical, lung disease, Abstracting and Indexing Information Academic Search (EBSCO Publishing) Academic Search Alumni Edition (EBSCO Publishing) Embase (Elsevier) Health & Medical Collection (ProQuest) Health Research Premium Collection (ProQuest) HEED: Health Economic Evaluations Database (Wiley-Blackwell) Hospital Premium Collection (ProQuest) Journal Citation Reports/Science Edition (Clarivate Analytics) MEDLINE/PubMed (NLM) ProQuest Central (ProQuest) Science Citation Index Expanded (Clarivate Analytics) SCOPUS (Elsevier)
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