부산대학교 도서관

Introduction: Pulmonary hemorrhage (PH) is a potentially life-threatening complication occurring in 10-16% of extremely low birth infants (ELBW), leading to chronic lung disease in 60% of cases. Surfactant is mainly used for early management of respiratory distress syndrome in preterm infants. Recently, therapeutic surfactant lavage with diluted surfactant has been proposed for the management of infants suffering from severe meconium aspiration syndrome (MAS).Case presentation: We report a case of a preterm infant (26 weeks GA) presenting with recurrent pulmonary hemorrhage in whom we performed a therapeutic lavage with diluted surfactant after an acute episode of massive bleeding with severe intractable hypoxemia. Repeated small aliquots of diluted surfactant (10 x 2 ml) allowed for marked improvement in oxygenation allowing to reduce mean airway pressures during high frequency oscillatory ventilation rapidly. The infant showed further progressive improvement allowing switching from HFOV back to conventional ventilation and finally extubation within 25 days.Conclusion: Bronchoalveolar lavage with diluted surfactant might be beneficial in massive pulmonary hemorrhage in infants. Further investigations are needed to clarify the potential benefit of such a therapeutic intervention on outcome of infants suffering from life-threatening PH.