This study was undertaken to evaluate the effectiveness and safety of use of an exogenous
surfactant in combined
therapy for acute
respiratory failure in children after cardiac surgery. In 2003 to 2004, the A. N. Bakulev Research Center of Cardiovascular Surgery, Russian Academy of Medical Sciences, used
Curosurf in 58 infants undergone cardiac surgery. The infants' age ranged from 1 day to 27 months (4.6 +/- 0.75 months); the
body weight was 1.1 to 14.8 kg (4.9 +/- 0.69 kg). According to the indications for replacement
therapy with
Curosurf, all the patients were divided into 4 groups: 1) 19 patients with acute pulmonary lesion syndrome; 2) 12 patients with bilateral
pneumonia; 3) 22 infants with recurrent
atelectases, and 4) 5 patients with
paresis of the cupula of the diaphragm. Group 1 patients receiving the exogenous
surfactant showed a significant increase in oxygenation and Cdyn, which allowed a significant reduction in the level of respiratory support. Group 2 patients were found to have similar changes, less pronounced as they were, in gas exchange and the mechanics of respiration. In most patients with recurrent
atelectases, a steady-state smoothing-out of the latter could be achieved. In Group 4 patients, the exogenous
surfactant did not affect the duration of artificial ventilation. Complications due to the administration of the exogenous
surfactant (
pneumothorax, short-term blood desaturation) were encountered rarely and readily arrested. As a whole,
Curosurf is an effective component of combined intensive
therapy for acute
respiratory failure in pediatric cardiosurgery.