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Surfactant Replacement Therapy for Adult Respiratory Distress Syndrome Due to Aspiration of Gastric Contents：A Case Report
Noriyuki Nishino,Kouhei Ohnishi,Takanori Aoki.
Rishi Island Central Hospital
Midoricho,Kutsugata,Rishiricho,Rishirign,Japan
Surfactant replacement therapy（SRT）is a useful therapeutic alternative in patients with adult respiratory distress syndrome（ARDS）associated with a wide variety of precipitating factors.
We report on a 63-year-old woman with ARDS due to aspiration of gastric contents who derived bnefit from SRT.
（The patient required assistnce with feeding and change of position because of severe depression）The patient drank an excessive amomt of water the night before admission and was found to have severe respiratory distress in the morning due to aspiration of gastric content.
There was no improvement despite ventilatory support with high concentrations of oxygen.The chest X-ray and CT-scan showed abnormal findings compatible with ARDS.A dose of 300mg of Surfactant-TA（Surfacten）was administered in divided doses into each of the five pulmonary lobes by instillation through the bronchoscope.This treatment resulted in significant increases in the arterial-alveolarP02 ratio.Oxygen requirements were reduced below the oxygen-toxicity limit of 60% by 12 hr and 30% by 36hr after SRT.
The chestX-ray and CT-scan taken on the 7th hospital day showed resolution of abnormal findings.The patient discharged with an uneventful recovery.
Keywords：?@aspiration、?Asurfactant replacement therapy（SRT）、?Badult respiratory distress syndrome（ARDS）
J Jan Soc Intensive Care Med 1996；3：215-221
