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A case of acute respiratory distress syndrome treated with surfactant and low dose methylprednisolone

Korean Journal of Pediatrics 2006;49(4):455-459.
Published online April 15, 2006.
A case of acute respiratory distress syndrome treated with surfactant and low dose methylprednisolone
Bo Yeon Choi, Kyong Mo Kim, Jong Seo Yoon, Joon Sung Lee
Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
표면활성제와 저용량 methylprednisolone으로 치료하였던 급성 호흡 곤란 증후군 1례
최보연, 김경모, 윤종서, 이준성
가톨릭대학교 의과대학 소아과학교실
Correspondence: 
Joon Sung Lee, Email: islee@catholic.ac.kr
Abstract
The major pathogenesis of acute respiratory distress syndrome (ARDS) is an inflammatory process that results from a diversity of injuries to the body. Due to the various cytokines and vasoactive peptides released from the endothelium, the vascular permeability is increased; the migration of inflammatory cells and the leakage of plasma proteins then occur and edema develops in the alveolus. There is a hypothesis that the impairment of alveolar recruitment in ARDS is caused by a defect of the surfactant system and the resultant increase of alveolar surface tension. This has been studied in pediatric patients in ARDS; after the administration of surfactant, hypoxia, respiratory symptoms and survival chances were improved. To alleviate the major pathogenic mechanism in this disease, that is to say, inflammation of the lung, steroids have been used and studied as another treatment modality for ARDS, and it has been concluded that the administration of low dose methylprednisolone may improve patients' symptoms and survival rates. We report here on a case of a young infant admitted with ARDS, who, after the intratracheal administration of 120 mg/kg surfactant, on PaO2/FiO2 was elevated. Subsequent low doses of methylprednisolone were given, and the symptoms did not recur, and no fibrotic change was shown during the follow-up period of 2 months.
Key Words: Acute respiratory distress syndrome , Surfactant , MethylprednisoloneIntroduction


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