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Effect of recombinant surfactant protein C-based surfactant on the acute respiratory distress syndrome.

Spragg, RG; Lewis, JF; Walmrath, H-D; Johannigman, J; Bellingan, G; Laterre, P-F; Witte, MC; ... Seeger, W; + view all (2004) Effect of recombinant surfactant protein C-based surfactant on the acute respiratory distress syndrome. N Engl J Med , 351 (9) pp. 884-892. 10.1056/NEJMoa033181. Green open access

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Abstract

BACKGROUND: Preclinical studies suggest that exogenous surfactant may be of value in the treatment of the acute respiratory distress syndrome (ARDS), and two phase 2 clinical trials have shown a trend toward benefit. We conducted two phase 3 studies of a protein-containing surfactant in adults with ARDS. METHODS: In two multicenter, randomized, double-blind trials involving 448 patients with ARDS from various causes, we compared standard therapy alone with standard therapy plus up to four intratracheal doses of a recombinant surfactant protein C-based surfactant given within a period of 24 hours. RESULTS: The overall survival rate was 66 percent 28 days after treatment, and the median number of ventilator-free days was 0 (68 percent range, 0 to 26); there was no significant difference between the groups in terms of mortality or the need for mechanical ventilation. Patients receiving surfactant had a significantly greater improvement in blood oxygenation during the initial 24 hours of treatment than patients receiving standard therapy, according to both univariate and multivariate analyses. CONCLUSIONS: The use of exogenous surfactant in a heterogeneous population of patients with ARDS did not improve survival. Patients who received surfactant had a greater improvement in gas exchange during the 24-hour treatment period than patients who received standard therapy alone, suggesting the potential benefit of a longer treatment course.

Type: Article
Title: Effect of recombinant surfactant protein C-based surfactant on the acute respiratory distress syndrome.
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1056/NEJMoa033181
Keywords: APACHE, Analysis of Variance, Causality, Double-Blind Method, Female, Humans, Logistic Models, Male, Middle Aged, Oxygen, Pulmonary Surfactant-Associated Protein C, Pulmonary Surfactants, Recombinant Proteins, Respiration, Artificial, Respiratory Distress Syndrome, Survival Rate, Treatment Failure
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Experimental and Translational Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/8024
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