Table 4 Transbronchial surfactant application in acute respiratory distress syndrome (ARDS)

Curosurf^® via bronchoscope

Gas exchange (PaO₂): ↑ (n.s.)

Spragg et al., 1994 [103]

50 mg/kg b.w.

Chest radiograph: ~

(uncontrolled trial)

Lung compliance: ~

Surfactant activity (BALF): ↑

Exosurf^® aerosolized for up to 5 days;

Gas exchange (PaO₂/FiO₂): ~

Anzueto et al., 1996 [91]

estimated dose delivered about

Survival at 30 days: ~

(prospective, multicenter,

5 mg/kg per day (control: 0.45% saline)

Duration of mechanical ventilation: ~

double-blind, randomized,

Length of stay in the ICU: ~

placebo-controlled)

Alveofact^® via bronchoscope

Gas exchange (PaO₂/FiO₂): ↑ (P < 0.001)

Walmrath et al., 1996 [68]

300 mg/kg b.w., augmentation to

Shunt flow: ↓ (P < 0.001)

(prospective, multicenter,

500 mg/kg b.w. possible

Surfactant activity (BALF): ↑ (P < 0.001)

uncontrolled)

Survanta^® via intratracheal instillation

Gas exchange (PaO₂/FiO₂):

Gregory et al., 1997 [88]

8 × 50 mg/kg b.w. (N = 8)

↑ (n.s., 8 × 50, 4 × 100 mg)

(prospective, controlled,

4 × 100 mg/kg b.w. (N = 16)

↑ (P < 0.01, 8 × 100 mg)

randomized, open-label trial)

8 × 100 mg/kg b.w. (N = 19)

Mortality: ~ (8 × 50 mg)

(control: no treatment)

↓ (P ≤ 0.075, 4 × 100 mg, 8 × 100 mg)

Surfactant activity (BALF): ↑

Infasurf^® via intratracheal instillation

Gas exchange (PaO₂/FiO₂): ↑ (P < 0.05)

Willson et al., 1999 [90]

2800 mg/m²

Duration of mechanical ventilation: ↓ (P < 0.03)

(prospective, multicenter,

(children with ARDS)

Days on the PICU: ↓ (P < 0.03)

randomized, controlled,

Days on oxygen: ↓ (P < 0.06)

unblinded trial)

Days in hospital: ↓ (P < 0.12)

Mortality: ~

Venticute^® via intratracheal instillation

Gas exchange (PaO₂/FiO₂): ↑ (MID)

Walmrath et al., 2000 [89]

MID (N = 14)

Ventilator-free days: ↑ (MID)

(prospective, controlled,

4 × 50 mg/kg b.w. PL

Weaned by day 28: ↑ (MID)

randomized, multicenter,

(= 4 × 1 mg/kg b.w. rSP-C)

Mortality: ↓ (MID)

open-label trial)

HIGH (N = 15)

No differences observed in the HIGH group

1 × 200 + 3 × 100 mg/kg b.w. PL

(= 1 × 4 + 3 × 2 mg/kg b.w. rSP-C)

STD (control): standard treatment (N = 12)