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ISSN 1025-0255 (Electronic)

2015, Number 4

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AMC 2015; 19 (4)

Exogenous surfactant as treatment for lung massive atelectasis

Rodríguez MVS, Quiroz VO, Oliva CCM, Díaz CE

Language: Spanish
References: 12
Page: 374-380
PDF size: 418.66 Kb.


ABSTRACT

Background: atelectasis is a collapse state and shortness of breath in part or all of one lung. Once the diagnosis of bronchial collapse is established, the treatment must be directed towards the find of the cause of obstruction and the infection that is usually concomitant.
Objective: to use bronchoalveolar lavage with exogenous surfactant (Surfacen®), along with respiratory physiotherapy as treatment.
Clinical case: the case of a sixteen-year-old female patient with a personal-pathological history of epilepsy since she was two years old is presented. The patient was under treatment with valproate sodium. She is admitted in the intensive care unit of "Dr. Eduardo Agramonte Piña" Pediatric Hospital. The patient is diagnosed clinically, radiologically and gasometrically as having respiratory distress syndrome of a direct pulmonary cause. On the fifth day of treatment the patient presented acute respiratory problems with sudden oxygenation fall and is diagnosed radiologically as having massive atelectasis of the left lung. She underwent a wide bronchoalveolar lavage with 9 % saline solution and then the instillation of exogenous surfactant in 100 mg doses diluted in 10 ml of water per injection administered intrabronchially twice a day. After the second bronchoalveolar lavage and the respiratory kinesiotherapy, the total expansion of the collapsed area and a notable improvement of the oxygenation parameters were achieved. The mechanical ventilation was moved five days after the complication. The patient kept a good subsequent progress.
Conclusions: the application of bronchoalveolar lavage with exogenous surfactant improved the oxygenation problem that causes massive atelectasis and allowed a rapid radiographic progress in the patient, as well as the decrease of the ventilatory parameters.


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