Effect of Recombinant Surfactant Protein C–Based Surfactant on the Acute Respiratory Distress Syndrome

• Published in: The New England journal of medicine Vol. 351; no. 9; pp. 884 - 892
• Main Authors: Spragg, Roger G, Lewis, James F, Walmrath, Hans-Dieter, Johannigman, Jay, Bellingan, Geoff, Laterre, Pierre-Francois, Witte, Michael C, Richards, Guy A, Rippin, Gerd, Rathgeb, Frank, Häfner, Dietrich, Taut, Friedemann J.H, Seeger, Werner
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 26-08-2004
• Subjects: Analysis of Variance; APACHE; Biological and medical sciences; Causality; Clinical trials; Double-Blind Method; Female; General aspects; Humans; Logistic Models; Lungs; Male; Medical sciences; Medical treatment; Middle Aged; Oxygen - blood; Pneumology; Proteins; Pulmonary Surfactant-Associated Protein C - adverse effects; Pulmonary Surfactant-Associated Protein C - therapeutic use; Pulmonary Surfactants - adverse effects; Pulmonary Surfactants - therapeutic use; Recombinant Proteins - adverse effects; Recombinant Proteins - therapeutic use; Respiration, Artificial; Respiratory diseases; Respiratory Distress Syndrome, Adult - drug therapy; Respiratory Distress Syndrome, Adult - etiology; Respiratory Distress Syndrome, Adult - mortality; Respiratory Distress Syndrome, Adult - therapy; Respiratory system : syndromes and miscellaneous diseases; Surfactants; Survival Rate; Treatment Failure; Medicine; Pulmonary surfactant; Respiratory disease; Acute; Respiratory distress; Protein C; Recombinant protein; Surfactant; Syndrome
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa033181

The acute respiratory distress syndrome (ARDS) results from a deficiency of functional surfactant in the airways. These investigators carried out a multicenter study in which patients with ARDS were treated with a recombinant human surfactant protein C–based surfactant. No clinical benefits were noted.
A multicenter study in which patients with ARDS were treated with a recombinant human surfactant protein C–based surfactant.
Although exogenous surfactant is of proven benefit in the prevention and treatment of the respiratory distress syndrome in infants,
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its value in treating patients with the acute respiratory distress syndrome (ARDS) has not been established. Whereas infants with an immature lung have a deficit in surfactant production, patients with ARDS have decreased surfactant production as well as biochemical alterations of endogenous surfactant that impair surface-tension–lowering properties and decreased surfactant function in distal airways.
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Normally, pulmonary surfactant phospholipids, acting in concert with surfactant proteins A, B, and C, cause alveolar surface tension to reach very low values at end expiration, thus . . .