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Case report
Surfactant therapy to facilitate weaning in paediatric patients dependent on extacorporeal membrane oxygenation
  1. Nikhil Achanta,
  2. Julia Vujcikova,
  3. Sahil Nichani and
  4. Sanjiv Nichani
  1. Paediatric Intensive Care Unit, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
  1. Correspondence to Dr Nikhil Achanta; nikhil.achanta{at}nhs.net

Abstract

We are reporting two paediatric cases with severe adenoviral acute respiratory distress syndrome with viral counts of 308 and 119 million copies/mL respectively, who required venoarterial extracorporeal membrane oxygenation (ECMO) support for nearly 3 weeks. They were static on ECMO and had shown a complete lack of response to all therapeutic interventions aimed at decreasing ECMO support. To facilitate weaning from ECMO, they received 2–3 doses of surfactant. This led to dramatic improvement in pulmonary compliance, oxygenation and chest X-ray. They were both weaned off ECMO within 24 hours of receiving surfactant. Surfactant was well tolerated, with no adverse effects. In both cases, weaning from ECMO was possible only after surfactant administration. From our experience, we conclude that surfactant administration is a potentially safe and effective treatment modality that helps weaning from ECMO and should be considered in patients who are dependent on ECMO for long duration.

  • paediatric intensive care
  • neonatal and paediatric intensive care
  • lung function

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Footnotes

  • Contributors NA has written up the case report submitted here from scratch as well as been involved directly with patient care. SanN was the lead consultant on the cases, and has supervised the writing of the case report. JV was also consultant on the cases and involved with patient care. SahN has helped in data collection essential for the write up of this case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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