The aim. To estimate efficacious of combined application of lung recruitment maneuver (LR) and surfactant administration for the treatment of ARDS after cardiac surgery. Materials and methods. 33 cardiac surgery patients with ARDS were included in to prospective, controlled non-randomized study. LR technique was used in 14 patients, who were included into the "LR" group. In 19 cases LR were combined with endobronchial administration of surfactant (Surfactant-BL, ”Biosurf” Russia), these patients were included into the "LR and surfactant" group. Results. Significant difference from baseline FiO 2 observed after 12 h in "LR and surfactant" group and after 24 h in "LR" group. Significant decrease from the baseline PEEP was observed after 48 h in "LR and surfactant" group and after 72 h in "LR" group. The duration of respiratory support was shorter in the "LR and surfactant" group: 87,5 ± 35,3 h vs 175,3 ± 52,5, p <0,001. There was significant difference in the incidences of ventilator-associated pneumonia (VAP): 10.5% in the "LR and surfactant" group and 42.9% in the "LR" group, p <0,05. Furthermore, we found significant difference in the ICU stay period between groups: 132,5 ± 42,2 h in the "LR and surfactant" group vs 282,5 ± 110,2 h in the "LR" group, p <0,01. There was no significant difference between two groups In mortality rate: 3 (15.8%) in the "LR and surfactant" group and 3 (21.4%) in the "LR" group. Conclusions. The combination of LR and surfactant administration decrease the time of respiratory support and ICU stay, reduce the risk of VAP.
PHARMACOLOGICAL AUGMENTATION OF LUNG RECRUITMENT EFFECTS LN THE THERAPY OF ACUTE RESPIRATORY DISTRESSSYNDROME AFTER CARDIAC SURGERY