surgoncoКреативная хирургия и онкологияCreative surgery and oncology2076-30932307-0501Башкирский государственный медицинский университет10.24060/2076-3093-2019-9-1-50-65surgonco-364Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWSПрепараты легочного сурфактанта и сурфактанттерапия ОРДС в условиях хирургической реанимации (обзор литературы)Pulmonary Surfactant Preparations and Surfactant Therapy for ARDS in Surgical Intensive Care (a Literature Review)РозенбергО. А.RosenbergO. A.

Розенберг Олег Александрович — доктор медицинских наук, профессор, руководитель лаборатории медицинской биотехнологии

197758, Санкт-Петербург, пос. Песочный, ул. Ленинградская, 70

Rosenberg Oleg Aleksandrovich — Doctor of Medical Sciences, Professor, Head of the Medical Biotechnology Laboratory 

70 Leningradskaya str., Saint Petersburg, village Pesochniy, 197758

ozenberg@biosurf.ruРоссийский научный центр радиологии и хирургических технологий им. акад. А.М. ГрановаРоссияGranov Russian Research Centre for Radiology and Surgical TechnologiesRussian Federation201925042019915065Copyright © Розенберг О.А., 20192019Розенберг О.А.Rosenberg O.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.surgonco.ru/jour/article/view/364Введение

Введение. Многолетние клинические исследования нескольких препаратов легочного сурфактанта при лечении острого респираторного дистресс-синдрома показали их высокую эффективность. В настоящее время препарат Сурфактант-БЛ используется в России и Республике Беларусь при этой патологии. Однако за рубежом при проведении III фазы испытаний не было получено положительных результатов. Сведения об этой проблеме в литературе достаточно ограниченны, что указывает на необходимость обобщить полученные Результаты.

Материалы и методы

Материалы и методы. Проведен анализ 87 отечественных и зарубежных публикаций, касающихся состава и свойств легочного сурфактанта и методов его применения для профилактики и лечения острого респираторного дистресс-синдрома.

Результаты

Результаты. Приведены сведения о результатах профилактики и лечения острого респираторного дистресс-синдрома у больных с сепсисом, тяжелой комбинированной травмой, ингаляционными поражениями, осложнениями при операциях на грудной клетке, реторакотомии, при реперфузионном синдроме, операциях на сердце и аорте, при тяжелой патологии в акушерско-гинекологической клинике и пневмонии при гриппе A/H1N1.

Обсуждение

Обсуждение. Анализ сведений, представленных в обзоре, показал, что своевременное (первые сутки развития острого респираторного дистресс-синдрома) применение природных препаратов легочного сурфактанта в комплексном лечении и профилактике острого респираторного дистресс-синдрома существенно уменьшает время нахождения больных на ИВЛ (до 6 суток), предотвращает развитие вентилятор-индуцированной и нозокомиальной пневмоний и снижает смертность от дыхательной недостаточности до 15–20 %. Впервые проведен анализ причин неудач третьей фазы многоцентровых рандомизированных клинических испытаний препаратов сурфактанта при лечении острого респираторного дистресс-синдрома за рубежом и приведены сведения о новых направлениях в разработке синтетических и порошковых препаратов легочного сурфактанта.

Заключение

Заключение. Анализ литературы о применении препаратов сурфактанта в условиях хирургической реанимации убеждает в высокой эффективности этой технологии в комплексной профилактике и лечении острого респираторного дистресс-синдрома, позволяющей в 2–4 раза снизить смертность при этом синдроме.

Introduction

Introduction. Despite the fact that clinical studies of pulmonary surfactants conducted over many years have demonstrated their efficacy for the treatment of acute respiratory distress syndrome (ARDS) which led to their approval for use inRussia andBelarus, only a few similar positive results have been achieved in other countries. This calls for an extensive literature review for intensive care professionals.

Materials and methods

Materials and methods. Using the data from 87 papers this review covers the composition, properties, methods of administration and delivery strategies of surfactant in the treatment and prevention of ARDS in patients with sepsis, severe complex injuries, inhalation injuries and a range of complications associated with thoracic and cardiovascular surgical procedures, massive blood transfusions, severe obstetric pathologies and the A/H1N1 pneumonia.

Results

Results. The early administration of natural pulmonary surfactants within 24 hours following the onset of ARDS as a part of the ARDS combination treatment or prevention drives down the time on mechanical ventilation to six days or shorter, prevents ventilator-associated and hospital-acquired pneumonias, bringing the respiratory failure mortality rate down to 15–20%.

Discussion

Discussion. Offering the first attempt to discuss the causes of failure of Phase III multicenter clinical trials outsideRussia andBelarus, this review outlines recent developments in synthetic and powdered pulmonary surfactant preparations.

Conclusion

Conclusion. Pulmonary surfactants are highly effective as a part of complex therapy in ARDS treatment and prevention, resulting in two to four fold drop in ARDS mortality rate. The timing of administration is seen as the key factor of the efficacy of surfactant therapy, explaining the differences in clinical trials results from different countries.

легочный сурфактантдистресс-синдромОРДСострый респираторный дистресс-синдромискусственная вентиляция легкихпрофилактикарандомизированное контролируемое клиническое исследованиеpulmonary surfactantrespiratory distress syndromeARDSacute respiratory distress syndromemechanical ventilationpreventionrandomized controlled trialReferencesClements J.A. Surface tension of lung extracts. Proc Soc Exp Biol Med. 1957;95(1):170–2. DOI: 10.3181/003797279523156Clements J.A. Surface tension of lung extracts. Proc Soc Exp Biol Med. 1957;95(1):170–2. DOI: 10.3181/003797279523156King R.J., Clements J.A. Surface active materials from dog lung: composition and physiological correlations. Am J Physiol. 1972;223(3):715– 26. PMID: 506862King R.J., Clements J.A. Surface active materials from dog lung: composition and physiological correlations. Am J Physiol. 1972;223(3):715– 26. PMID: 506862Bangham A.D. Artificial lung expanding compound (ALECtm). In: Lasic D.D., Papahajopoulos D. (editors). Medical applications of liposomes. Elsevier Science; 1998. P. 452–5. DOI: 10.1016/B978 0444829177/500260Bangham A.D. Artificial lung expanding compound (ALECtm). In: Lasic D.D., Papahajopoulos D. (editors). Medical applications of liposomes. Elsevier Science; 1998. P. 452–5. DOI: 10.1016/B9780444829177/500260Schürch S., Goerke J., Clements J.A. Direct determination of volume and time dependence of alveolar surface tension in excised lungs. Proc Natl Acad Sci USA. 1978;75(7):3417–20. PMID: 277943Schürch S., Goerke J., Clements J.A. Direct determination of volume and time dependence of alveolar surface tension in excised lungs. Proc Natl Acad Sci USA. 1978;75(7):3417–20. PMID: 277943Bonchuk-Dayanikli P., Taeusch W.H. Essential and nonessential constituents of exogenous surfactants. In: Robertson B., Taeusch H.W. (editors). Surfactant therapy for lung disease. Lung biology in health and disease. New York: Marcel Dekker Inc; 1995. P. 217–38.Bonchuk-Dayanikli P., Taeusch W.H. Essential and nonessential constituents of exogenous surfactants. In: Robertson B., Taeusch H.W. (editors). Surfactant therapy for lung disease. Lung biology in health and disease. New York: Marcel Dekker Inc; 1995. P. 217–38.Sanders R.L. The composition of pulmonary surfactant. In: Farrell P.M. (editor). Lung development: Biological and clinical perspectives. New York: Academic Press; 1982. P. 193–210.Sanders R.L. The composition of pulmonary surfactant. In: Farrell P.M. (editor). Lung development: Biological and clinical perspectives. New York: Academic Press; 1982. P. 193–210.Possmayer F. A proposed nomenclature for pulmonary surfactant-associated proteins. Am Rev Respir Dis. 1988;138(4):990–8. DOI: 10.1164/ajrccm/138.4.990Possmayer F. A proposed nomenclature for pulmonary surfactant-associated proteins. Am Rev Respir Dis. 1988;138(4):990–8. DOI: 10.1164/ajrccm/138.4.990Knoor A., Gray M.E., Hull W.M., Whitsett J.A., Stahlman M.T. Developmental expression of SP-A and SP-A mRNA in the proximal and distal respiratory epithelium in the human fetus and newborn. J Histochem Cytochem. 1993;41(9):1311–19. PMID: 8354874Knoor A., Gray M.E., Hull W.M., Whitsett J.A., Stahlman M.T. Developmental expression of SP-A and SP-A mRNA in the proximal and distal respiratory epithelium in the human fetus and newborn. J Histochem Cytochem. 1993;41(9):1311–19. PMID: 8354874Розенберг О.А. Легочный сурфактант и его применение при заболеваниях легких. Общая реаниматология. 2007;3(1):66–77. DOI: 10.15360/1813-9779-2007-1-66-77Rozenberg O.A. Lung surfactant and its use in lung diseases. General Reanimatology. 2007;3(1):66–77 (In Russ.). DOI: 10.15360/1813-97792007-1-66-77Cocksgutt A., Absolom D., Possmayer F. The role of palmitic acid in pulmonary surfactant: enhancement of surface activity and prevention of inhibition by blood proteins. Biochim Biophys Acta. 1991;1085(2):248–56. DOI: 10.1016/00052760(91)90101MCocksgutt A., Absolom D., Possmayer F. The role of palmitic acid in pulmonary surfactant: enhancement of surface activity and prevention of inhibition by blood proteins. Biochim Biophys Acta. 1991;1085(2):248–56. DOI: 10.1016/00052760(91)90101MOrgeig S., Daniels C.B. The roles of cholesterol in pulmonary surfactant: insights from comparative and evolutionary studies. Comp Biochem Physiol A Mol Integr Physiol. 2001;129(1):75–89. DOI: 10.1016/S10956433(01)00307-5Orgeig S., Daniels C.B. The roles of cholesterol in pulmonary surfactant: insights from comparative and evolutionary studies. Comp Biochem Physiol A Mol Integr Physiol. 2001;129(1):75–89. DOI: 10.1016/S10956433(01)00307-5van Iwaarden F.J., van Golde L.M.J. Pulmonary surfactant and lung defense. In: Robertson B., Taeusch H.W. (editors). Surfactant therapy for lung disease. Lung biology in health and disease. New York: Marcel Dekker Inc; 1995. P. 75–84.van Iwaarden F.J., van Golde L.M.J. Pulmonary surfactant and lung defense. In: Robertson B., Taeusch H.W. (editors). Surfactant therapy for lung disease. Lung biology in health and disease. New York: Marcel Dekker Inc; 1995. P. 75–84.Phelps D.S. Surfactant regulation of host defense function in the lung: a question of balance. Pediatr Pathol Mol Med. 2001;20(4):269–74. DOI: 10.1080/152279501750412225Phelps D.S. Surfactant regulation of host defense function in the lung: a question of balance. Pediatr Pathol Mol Med. 2001;20(4):269–74. DOI: 10.1080/152279501750412225van Iwaarden J.F., Claassen E., Jeurissen S.H., Haagsman H.P., Kraal G. Alveolar macrophages, surfactant lipids, and surfactant protein B regulate the induction of immune responses via the airways. Am J Respir Cell Mol Biol. 2001;24(4):452–8. DOI: 10.1165/ajrcmb.24.4.4239van Iwaarden J.F., Claassen E., Jeurissen S.H., Haagsman H.P., Kraal G. Alveolar macrophages, surfactant lipids, and surfactant protein B regulate the induction of immune responses via the airways. Am J Respir Cell Mol Biol. 2001;24(4):452–8. DOI: 10.1165/ajrcmb.24.4.4239Ikegami M. SP-B protects lung from inflammation. Appl Cardiopulm Pathophysiol. 2004;13(1):45–7. DOI: 10.1165/rcmb.2002-0071OCIkegami M. SP-B protects lung from inflammation. Appl Cardiopulm Pathophysiol. 2004;13(1):45–7. DOI: 10.1165/rcmb.2002-0071OCClark H., Palaniyar N., Strong P., Edmondson J., Hawgood S., Reid K.B. Surfactant protein reduces alveolar macrophage apoptosis in vivo. J Immunol. 2002;169(6):2892–9. DOI: 10.4049/jimmunol.169.6.2892Clark H., Palaniyar N., Strong P., Edmondson J., Hawgood S., Reid K.B. Surfactant protein reduces alveolar macrophage apoptosis in vivo. J Immunol. 2002;169(6):2892–9. DOI: 10.4049/jimmunol.169.6.2892Halliday H.L. Surfactants: past, present and future. J Perinatol. 2008;28:47–56. DOI: 10.1038/jp.2008.50Halliday H.L. Surfactants: past, present and future. J Perinatol. 2008;28:47–56. DOI: 10.1038/jp.2008.50Avery M.E., Mead J. Surface properties in relation to atelectasis and hyaline membrane disease. Am J Dis Child. 1959;97(5Pt1):517–23. DOI: 10.1001/archpedi.1959.02070010519001Avery M.E., Mead J. Surface properties in relation to atelectasis and hyaline membrane disease. Am J Dis Child. 1959;97(5Pt1):517–23. DOI: 10.1001/archpedi.1959.02070010519001Northway W.H. Jr, Rosan R.C., Porter D.Y. Pulmonary disease following respiratory therapy of hyaline membrane disease. N Engl J Med. 1967;276:357–68. DOI: 10.1056/NEJM196702162760701Northway W.H. Jr, Rosan R.C., Porter D.Y. Pulmonary disease following respiratory therapy of hyaline membrane disease. N Engl J Med. 1967;276:357–68. DOI: 10.1056/NEJM196702162760701Cherukupalli K., Larson J.E., Rotschild A., Thurlbeck WM. Biochemical, clinical, and morphologic studies on lungs of infants with bronchopulmonary dysplasia. Pediatr Pulmonol. 1996;22(4):215–21. PMID: 8905882Cherukupalli K., Larson J.E., Rotschild A., Thurlbeck WM. Biochemical, clinical, and morphologic studies on lungs of infants with bronchopulmonary dysplasia. Pediatr Pulmonol. 1996;22(4):215–21. PMID: 8905882Ashbaugh D.G., Bigelow D.B., Petty T.L., Levine B.E. Acute respiratory distress in adults. Lancet. 1967;290(7511):319–23. DOI: 10.1016/S01406736(67)90168-7Ashbaugh D.G., Bigelow D.B., Petty T.L., Levine B.E. Acute respiratory distress in adults. Lancet. 1967;290(7511):319–23. DOI: 10.1016/S01406736(67)90168-7Lewis J.F., Jobe A.H. Surfactant and the adult respiratory distress syndrome. Am Rev Respir Dis. 1993;147(1):218–33. DOI: 10.1164/ajrccm/147.1.218Lewis J.F., Jobe A.H. Surfactant and the adult respiratory distress syndrome. Am Rev Respir Dis. 1993;147(1):218–33. DOI: 10.1164/ajrccm/147.1.218Schmidt R., Meier U., Yabut Perez M., Walmrath D., Grimminger F., Seeger W., et al. Alteration of fatty acid profiles in different pulmonary surfactant phospholipids in acute respiratory distress syndrome and pneumonia. Am J Resp Сrit Care Med. 2001;163(1):95–100. DOI: 10.1164/ajrccm.163.1.9903029Schmidt R., Meier U., Yabut Perez M., Walmrath D., Grimminger F., Seeger W., et al. Alteration of fatty acid profiles in different pulmonary surfactant phospholipids in acute respiratory distress syndrome and pneumonia. Am J Resp Сrit Care Med. 2001;163(1):95–100. DOI: 10.1164/ajrccm.163.1.9903029Griese M., Birrer P., Demirsoy A. Pulmonary surfactant in cystic fibrosis. Eur Respir J. 1997;10(9):1983–97. DOI: 10.1183/09031936.97.10091983Griese M., Birrer P., Demirsoy A. Pulmonary surfactant in cystic fibrosis. Eur Respir J. 1997;10(9):1983–97. DOI: 10.1183/09031936.97.10091983McCormack F.X., King T.E. Jr, Voelker D.R., Robinson P.C., Mason R.J. Idiopathic pulmonary fibrosis. Abnormalities in the bronchoal-veolar lavage content of surfactant protein A. Am Rev Respir Dis. 1991;144(1):160–9. DOI: 10.1164/ajrccm/144.1.160McCormack F.X., King T.E. Jr, Voelker D.R., Robinson P.C., Mason R.J. Idiopathic pulmonary fibrosis. Abnormalities in the bronchoalveolar lavage content of surfactant protein A. Am Rev Respir Dis. 1991;144(1):160–9. DOI: 10.1164/ajrccm/144.1.160Oyarzun M.J., Stevens P., Clemens J.A. Effect of lung collapse on alveolar surfactant in rabbits subjected to unilateral pneumothorax. Exp Lung Res. 1990;15(6):909–24. DOI: 10.3109/01902148909069635Oyarzun M.J., Stevens P., Clemens J.A. Effect of lung collapse on alveolar surfactant in rabbits subjected to unilateral pneumothorax. Exp Lung Res. 1990;15(6):909–24. DOI: 10.3109/01902148909069635Hallman M., Maasilta P., Kivisaari L., Mattson K. Changes in surfactant in bronchoalveolar lavage fluid after hemithorax irradiation in patients with mesothelioma. Am Rev Respir Dis. 1990;141(4 Pt1):998–1007. DOI: 10.1164/ajrccm/141.4_Pt_1.998Hallman M., Maasilta P., Kivisaari L., Mattson K. Changes in surfactant in bronchoalveolar lavage fluid after hemithorax irradiation in patients with mesothelioma. Am Rev Respir Dis. 1990;141(4 Pt1):998–1007. DOI: 10.1164/ajrccm/141.4_Pt_1.998Hohlfeld J.M., Ahlf K., Enhorning G., Balke K., Erpenbeck V.J., Petschallies J., et.al. Dysfunction of pulmonary surfactant in asthmatics after segmental allergen challenge. Am J Respir Crit Care Med. 1999;159(6):1803–9. DOI: 10.1164/ajrccm.159.6.9806145Hohlfeld J.M., Ahlf K., Enhorning G., Balke K., Erpenbeck V.J., Petschallies J., et.al. Dysfunction of pulmonary surfactant in asthmatics after segmental allergen challenge. Am J Respir Crit Care Med. 1999;159(6):1803–9. DOI: 10.1164/ajrccm.159.6.9806145Devendra G., Spragg R.G. Lung surfactant in subacute pulmonary disease. Respir Res. 2002;3(1):19. DOI: 10.1186/rr168Devendra G., Spragg R.G. Lung surfactant in subacute pulmonary disease. Respir Res. 2002;3(1):19. DOI: 10.1186/rr168Günther A., Schmidt R., Nix F., Yabut Perez M., Guth C., Rosseau S., et al. Surfactant abnormalities in idiopathic pulmonary fibrosis, hypersensitivity pneumonitis and sarcoidosis. Eur Respir J. 1999;14(3):565– 73. DOI: 10.1034/j.13993003.1999.14c14.xGünther A., Schmidt R., Nix F., Yabut Perez M., Guth C., Rosseau S., et al. Surfactant abnormalities in idiopathic pulmonary fibrosis, hypersensitivity pneumonitis and sarcoidosis. Eur Respir J. 1999;14(3):565– 73. DOI: 10.1034/j.13993003.1999.14c14.xЕрохин В.В., Романова Л.К. Сурфактантная система легких. В кн.: Ерохин В.В., Романова Л.К. (ред.). Клеточная биология легких в норме и при патологии. Руководство для врачей. М.: Медицина; 2000. C. 167–81.Erokhin V.V., Romanova L.K. Pulmonary surfactant system. In: Erokhin V.V., Romanova V.V. (editors). Lung cellular biology in health and disease. A manual for physicians. Moscow: Meditsina Publ.; 2000. P. 167–181 (In Russ.).Fujiwara T., Maeta H., Chida S., Morita T., Watabe Y., Abe T. Artificial surfactant therapy in hyaline membrane disease. Lancet. 1980;1(8159):55–9. DOI: 10.1016/S01406736(80)904894Fujiwara T., Maeta H., Chida S., Morita T., Watabe Y., Abe T. Artificial surfactant therapy in hyaline membrane disease. Lancet. 1980;1(8159):55–9. DOI: 10.1016/S01406736(80)904894Розенберг О.А. Препараты легочного сурфактанта при острых и хронических заболеваниях легких (Часть II). Общая реаниматология. 2014;10(5):69–86. DOI: 10.15360/1813-9779-2014-5-69-86Rozenberg O.A. Pulmonary surfactants for acute and chronic lung diseases (Part II). General Reanimatology. 2014;10(5):69–86 (In Russ.). DOI: 10.15360/1813-9779-2014-5-69-86Lachmann B. Surfactant replacement in acute respiratory failure: Animal studies and first clinical trials. In: Lachmann B. (editor). Surfactant replacement therapy. New York: Springer Verlag; 1987. P. 212–20.Lachmann B. Surfactant replacement in acute respiratory failure: Animal studies and first clinical trials. In: Lachmann B. (editor). Surfactant replacement therapy. New York: Springer Verlag; 1987. P. 212–20.Spragg R.G. Current status of surfactant treatment of ARDS/ALI. Appl Cardiopulm Pathophysiol. 2004;13(1):88–90.Spragg R.G. Current status of surfactant treatment of ARDS/ALI. Appl Cardiopulm Pathophysiol. 2004;13(1):88–90.Зильбер А.П. Синдром острого легочного повреждения. В кн.: Зильбер А.П. Этюды респираторной медицины. М.: МЕДпрессинформ; 2007. С. 478–530.Zil’ber A.P. The syndrome of acute lung injury. In: Zil’ber A.P. Sketches of respiratory medicine. Moscow: MEDpress-inform; 2007. P. 478–530 (In Russ.).Bernard G.R., Artigas A., Brigham K.L., Carlet J., Falke K., Hudson L., et al. The American European consensus conference on ARDS: Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med. 1994;149(3Pt1):818–24. DOI: 10.1164/ajrccm.149.3.7509706Bernard G.R., Artigas A., Brigham K.L., Carlet J., Falke K., Hudson L., et al. The American European consensus conference on ARDS: Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med. 1994;149(3Pt1):818–24. DOI: 10.1164/ajrccm.149.3.7509706Thompson B.T., Ferguson N.D., Caldwell E., Fan E., Camporota L., Slutsky A.S. Acute respiratory distress syndrome: Berlin definition. JAMA. 2012;307(23):2526–33. DOI: 10.1001/jama.2012.5669Thompson B.T., Ferguson N.D., Caldwell E., Fan E., Camporota L., Slutsky A.S. Acute respiratory distress syndrome: Berlin definition. JAMA. 2012;307(23):2526–33. DOI: 10.1001/jama.2012.5669Баутин А.Е., Розенберг О.А., Сумин С.А. Острый респираторный дистресс-синдром. В кн.: Сумин С.А., Шаповалов К.Г. (ред.). Анестезиология и реаниматология. М.: МИА; 2018. С. 103–19.Bautin A.E., Rozenberg O.A., Sumin S.A. Acute respiratory distress syndrome In: Sumin S.A., Shapovalov K.G. (editors). Anesthesiology and Reanimatology. Moscow: MIA; 2018. P. 103–19 (In Russ.).Мороз В.В., Голубев А.М. Классификация острого респираторного дистресс-синдрома. Общая реаниматология. 2007;3(5–6):5–9. DOI: 10.15360/1813-9779-2007-6-7-9Moroz V.V., Golubev A.M. Classification of acute respiratory distress syndrome. General Reanimatology. 2007;3(6):7–9 (In Russ.). DOI: 10.15360/1813-9779-2007-6-7-9Eworuke E., Major J.M., Gilbert McClain L.I. National incidence rates for Acute Respiratory Distress Syndrome (ARDS) and ARDS cause-specific factors in the United States (2006–2014). J Crit Care. 2018;47:192–7. DOI: 10.1016/j.jcrc.2018.07.002Eworuke E., Major J.M., Gilbert McClain L.I. National incidence rates for Acute Respiratory Distress Syndrome (ARDS) and ARDS cause-specific factors in the United States (2006–2014). J Crit Care. 2018;47:192–7. DOI: 10.1016/j.jcrc.2018.07.002Кассиль В.Л., Сапичева Ю.Ю. Острый респираторный дистресссиндром и гипоксемия. М.: МЕДпресс-информ; 2016. 150 с.Kassil’ V.L., Sapicheva Y.U. Acute respiratory distress syndrome and hypoxemia. Moscow: MEDpress-inform; 2016. 150 p. (In Russ.).Gregory T.J., Steinberg K.P., Spragg R., Gadek J.E., Hyers T.M., Longmore W. J., et al. Bovine surfactant therapy for patients with acute respiratory distress syndrome. Am J Respir Crit Care Med. 1997;155(4):1309–15. DOI: 10.1164/ajrc-cm.155.4.9105072Gregory T.J., Steinberg K.P., Spragg R., Gadek J.E., Hyers T.M., Longmore W.J., et al. Bovine surfactant therapy for patients with acute respiratory distress syndrome. Am J Respir Crit Care Med. 1997;155(4):1309–15. DOI: 10.1164/ajrc-cm.155.4.9105072Rosenberg O.A., Bautin A.E., Osovskich V.V., Tsibulkin E.K., Gavrilin S.V., Kozlov I.A., et al. When to start surfactant therapy (STtherapy) of acute lung injury? Eur Respir J. 2001;18(Suppl 38):153.Rosenberg O.A., Bautin A.E., Osovskich V.V., Tsibulkin E.K., Gavrilin S.V., Kozlov I.A., et al. When to start surfactant therapy (STtherapy) of acute lung injury? Eur Respir J. 2001;18(Suppl 38):153.Willson D.F., Thomas N.J., Markovitz B.P., Bauman L.A., DiCarlo J.V., Pon S., et al. Pediatric acute lung injury and sepsis investigators. Effect of exogenous surfactant (Calfactant) in pediatric acute lung injury: a randomized controlled trial. JAMA. 2005;293(4):470–6. PMID: 15671432Willson D.F., Thomas N.J., Markovitz B.P., Bauman L.A., DiCarlo J.V., Pon S., et al. Pediatric acute lung injury and sepsis investigators. Effect of exogenous surfactant (Calfactant) in pediatric acute lung injury: a randomized controlled trial. JAMA. 2005;293(4):470–6. PMID: 15671432Rodríguez-Moya V.S. Machado-Lubián María del C., Barrese-Pérez Y., Ávila-Albuerne Y., Uranga-Piña R., Blanco-Hidalgo O., et al. Cuban exogenous pulmonary surfactant in treatment of pediatric acute respiratory distress syndrome. Int J Cuban Health Med. 2017;19(2–3):24–31. DOI: 10.1590/medicc.2017.1902030006Rodríguez-Moya V.S. Machado-Lubián María del C., Barrese-Pérez Y., Ávila-Albuerne Y., Uranga-Piña R., Blanco-Hidalgo O., et al. Cuban exogenous pulmonary surfactant in treatment of pediatric acute respiratory distress syndrome. Int J Cuban Health Med. 2017;19(2-3):24–31. DOI: 10.1590/medicc.2017.1902030006Anzueto A., Baughman R.P., Guntupalli K.K., Weg J.G., Wiedemann H.P., Raventós A.A., et al. Aerosolized surfactant in adults with septic induced acute respiratory distress syndrome. N Engl J Med. 1996;334(22):1417–21. PMID: 8618579Anzueto A., Baughman R.P., Guntupalli K.K., Weg J.G., Wiedemann H.P., Raventós A.A., et al. Aerosolized surfactant in adults with septic induced acute respiratory distress syndrome. N Engl J Med. 1996;334(22):1417–21. PMID: 8618579Taeusch H.W., Karen L.U., Ramierez-Schrempp D. Improving pulmonary surfactants. Acta Pharmacol Sin. 2002;11:15–8.Taeusch H.W., Karen L.U., Ramierez-Schrempp D. Improving pulmonary surfactants. Acta Pharmacol Sin. 2002;11:15–8.Lachmann B. Open up the lung and keep the lung open. Intensive Care Med. 1992;18(6):319–21. DOI: 10.1007/BF01694358Lachmann B. Open up the lung and keep the lung open. Intensive Care Med. 1992;18(6):319–21. DOI: 10.1007/BF01694358Баутин А.Е., Осовских В.В., Хубулава Г.Г., Гранов Д.А., Козлов И.А., Ерохин В.В. и др. Многоцентровые клинические испытания сурфактантаBL для лечения респираторного дистресс-синдрома взрослых. Клинические исследования лекарственных средств в России. 2002;(2):18–23.Bautin A.E., Osovskikh V.V., Khubulava G.G., Granov D.A., Kozlov I.A., Erokhin V.V., et al. Multicenter clinical trials of surfactantBL for the treatment of adult respiratory distress syndrome. Clinical research of drugs in Russia. 2002;(2):18–23 (In Russ.).Баутин А.Е., Наумов А.Б., Рубинчик В.Е., Осовских В.В., Этин В.Л., Розенберг О.А. Применение препарата экзогенного сурфактанта в кардиохирургических клиниках Санкт-Петербурга: от разработки методик к эволюции лечебной тактики. Трансляционная медицина. 2014;(1):92–7. DOI: 10.18705/2311-4495-2014-0-1-92-97Bautin A.E., Naumov A.B., Rubinchik V.E., Osovskikh V.V., Etin V.L., Rosenberg O.A. Applying of the exogenous surfactant in the cardiac surgery clinics of St. Petersburg: from the technology to the evolution of therapeutic strategy. Translational Medicine. 2014;(1):92–7 (In Russ.). DOI: 10.18705/2311-4495-2014-0-1-92-97Мороз В.В., Власенко А.В., Голубев А.М., Яковлев В.Н., Алексеев В.Г., Булатов Н.Н. и др. Патогенез и дифференциальная диагностика острого респираторного дистресс-синдрома, обусловленного прямыми и непрямыми этиологическими факторами. Общая реаниматология. 2011;7(3):5. DOI: 10.15360/1813-9779-2011-3-5Moroz V.V., Vlasenko A.V., Golubev A.M., Yakovlev V.N., Alekseyev V.G., Bulatov N.N., et al. The pathogenesis and differential diagnosis of acute respiratory distress syndrome induced by direct and indirect etiological factors. General Reanimatology. 2011;7(3):5 (In Russ.). DOI: 10.15360/1813-9779-2011-3-5Власенко А.В., Остапченко Д.А., Мороз В.В., Розенберг О.А., Закс И.О., Линев Д.В. Применение Сурфактанта BL у взрослых больных с острым респираторным дистресс-синдромом. Общая реаниматология. 2005;1(6):21–9. DOI: 10.15360/1813-9779-2005-6-21-29Vlasenko A.V., Ostapchenko D.A., Moroz V.V., Rozenberg O.A., Zaks I.O., Linev D.V. Use of Surfactant-BL in adult patients with acute respiratory distress syndrome. General Reanimatology. 2005;1(6):21–9 (In Russ.). DOI: 10.15360/1813-9779-2005-6-21-29Bautin A., Khubulava G., Kozlov I., Poptzov V., Osovskikh V., Seiliev A., et al. Surfactant therapy for patients with ARDS after cardiac surgery. J Liposome Res. 2006;16(3):265–72. DOI: 10.1080/08982100600850997Bautin A., Khubulava G., Kozlov I., Poptzov V., Osovskikh V., Seiliev A., et al. Surfactant therapy for patients with ARDS after cardiac surgery. J Liposome Res. 2006;16(3):265–72. DOI: 10.1080/08982100600850997Козлов И.А., Романов А.А. Маневр открытия («мобилизация») альвеол при интраоперационном нарушении оксигенирующей функции легких у кардиохирургических больных. Анестезиология и реаниматология. 2007;(2):27–31.Kozlov I.A., Romanov A.A. Alveolar opening maneuver (mobilization) in intraoperative pulmonary oxygenizing dysfunction in cardiosurgical patients. Russian journal of anesthesiology and reanimatology. 2007;2:27–31 (In Russ.).Козлов И.А., Попцов В.Н. Сочетанная терапия оксидом азота и Cурфактантом-BL при остром респираторном дистресс-синдроме после операций с искусственным кровообращением. Общая реаниматология. 2005;1(1):15–9. DOI: 10.15360/1813-9779-2005-1-15-19Kozlov I.A., Poptsov V.N. Combined therapy with nitric oxide and SurfactantBL for acute respiratory distress syndrome after operations using extracorporeal circulation. General Reanimatology. 2005;1(1):15–9 (In Russ.). DOI: 10.15360/1813-9779-2005-1-15-19Шлык И.В., Крылов K.M., Зуева Л.П., Стасова Н.Б. Эпидемиологический мониторинг в отделении ожоговой реанимации. Инфекции в хирургии. 2008;6(3):23–8.Shlyk I.V., Krylov K.M., Zueva L.P., Stasova N.B. Epidemiological monitoring in a burn intensive care unit. Infections in Surgery. 2008;6(3):23–8 (In Russ.).Tarasenko M., Shpakov I., Kallistov D., Venevetinov I., Akulinov E., Tikhonov A., et al. Surfactant therapy — the real chance to survive for the patients with severe inhalation injury. Eur Respir J. 2004;24(Suppl 48):4127.Tarasenko M., Shpakov Ig., Kallistov D., Venevetinov Ig., Akulinov E., Tikhonov A., et al. Surfactant therapy — the real chance to survive for the patients with severe inhalation injury. Eur Respir J. 2004;24(Suppl 48):4127.Тарасенко М.Ю., Шпаков И.Ф., Акулинов Е.Е., Адмакин А.Л., Петрачков С.А., Гранов Д.А. и др. Способ лечения ингаляционных поражений: пат. 2238757 РФ, 2003.Tarasenko M.Yu., Shpakov I.F., Akulinov E.E., Admakin A.L., Petrachkov S.A., Granov D.A., et al. Treatment option for inhaled lesions. Russian Federation Patent RU 2238757; Jun. 24, 2003 (In Russ.).Почепень О.Н., Золотухина Л.В., Земец Е.А., Трояновский Е.С. Опыт применения Сурфактанта-БЛ при прямом и непрямом повреждении легких у пациентов с обширными ожогами в Республике Беларусь. Скорая медицинская помощь. 2011;12(3):44–7.Pochepen O.N., Zolotuhina L.V., Zemec E.A., Troyanovskiy E.S. The use of surfactant-BL in treatment of inhalation injury after severe burns. Emergency medical care. 2011;12(3):44–7 (In Russ.).Пылаев А.В., Бабанин А.А. Применение заместительной сурфактантной терапии в комплексном лечении синдрома острого легочного повреждения при термоингаляционном поражении. Таврический медико-биологический вестник. 2010;13(4):150–4.Pylaev A.V., Babanin A.A. Use of surfactant replacement therapy in the combination treatment of acute lung injury syndrome in the presence of thermal inhalation injury. Tavricheskiy Mediko-Biologicheskiy Vestnik. 2010;13(4):150–4 (In Russ.).Pallua N., Warbanow K., Noah E.M., Machens H.G., Poets C., Bernhard W., et al. Intrabronchial surfactant application in cases of inhalation injury: First results from patients with severe burns and ARDS. Burns. 1998;24(3):197–206. DOI: 10.1016/S03054179(97)001125Pallua N., Warbanow K., Noah E.M., Machens H.G., Poets C., Bernhard W., et al. Intrabronchial surfactant application in cases of inhalation injury: First results from patients with severe burns and ARDS. Burns. 1998;24(3):197–206. DOI: 10.1016/S03054179(97)001125Геккиева О.В., Баутин А.Е., Осовских В.В., Трегубова И.В., Козетинский Р.А., Сейлиев А.А. и др. Профилактическое применение препарата сурфактанта при операциях на органах грудной полости с высоким риском развития дыхательной недостаточности. Доктор.Ру. 2016;(12):38–43.Gekkieva O.V., Bautin A.E., Osovskih V.V., Tregubova I.V., Kozetinskij R.A., Sejliev A.A., et al. Preventive treatment with surfactant in thoracic surgeries associated with high risk of respiratory failure. Doktor.Ru. 2016;(12):38–43 (In Russ.).Leone M., Delliaux S., Bourgoin A., Albanese J., Garnier F., Boyadjiev I., et al. Risk factors for late-onset ventilator-associated pneumonia in trauma patients receiving selective digestive decontamination. Intensive Care Med. 2005;16:64–70. DOI: 10.1007/s00134-004-2514-zLeone M., Delliaux S., Bourgoin A., Albanese J., Garnier F., Boyadjiev I., et al. Risk factors for late-onset ventilator-associated pneumonia in trauma patients receiving selective digestive decontamination. Intensive Care Med. 2005;16:64–70. DOI: 10.1007/s00134-004-2514-zForel J., Voillet F., Pulina D. Ventilator-associated pneumonia and ICU mortality in severe ARDS patients ventilated according to a lungprotective strategy. Crit Care. 2012;16:R65. DOI: 10.1186/cc11312Forel J., Voillet F., Pulina D. Ventilator-associated pneumonia and ICU mortality in severe ARDS patients ventilated according to a lungprotective strategy. Crit Care. 2012;16:R65. DOI: 10.1186/cc11312Хубутия М.Ш., Романов А.А., Курилова О.А., Тимербаев В.Х., Первакова Э.И., Поплавский И.В. и др. Раннее использование Сурфактанта-БЛ при трансплантации легких. Общая реаниматология. 2013;9(2):12–7. DOI: 10.15360/1813-9779-2013-2-12-17Khubutiya M.Sh., Romanov A.A., Kurilova O.A., Timerbayev V.Kh., Pervakova E.I., Poplavsky I.V., et al. Early use of Surfactant-BL after lung transplantation. General Reanimatology. 2013;9(2):12–7 (In Russ.). DOI: 10.15360/1813-9779-2013-2-12-17Cole D.E., Taylor T.L., McCullough D.M., Shoff C.T., Derdak S. Acute respiratory distress syndrome in pregnancy. Crit Care Med. 2005;33(10Suppl):S269–78. PMID: 16215347Cole D.E., Taylor T.L., McCullough D.M., Shoff C.T., Derdak S. Acute respiratory distress syndrome in pregnancy. Crit Care Med. 2005;33(10Suppl):S269–78. PMID: 16215347Кукарская И.И., Швечкова М.В., Кураценко И.И., Савва К.Н. Опыт применения Сурфактанта-БЛ при СОПЛ/ОРДС у акушерских больных. Медицинская наука и образование Урала. 2012;13(1):61–3.Kukarskaya I.I., Shvechkova M.V., Kuratsenko I.I., Savva K.N. Experience with Surfactant-BL in obstetric patients with ALJS/ARDS. Medical Science and Education of Ural. 2012;13(1):60–2. (In Russ.).Швечкова М.В. Клинические особенности и интенсивная терапия респираторного дистресс-синдрома в акушерстве: дисс. … канд. мед. наук. Тюмень; 2017.Shvechkova M.V. Clinical features and intensive care of respiratory distress syndrome in obstetrics [dissertation]. Tyumen; 2017 (In Russ.).Napolitano L.M., Park P.K., Raghavendran K., Bartlett R.H. Nonventilatory strategies for patients with life-threatening 2009 А/H1N1 influenza and severe respiratory failure. Crit Care Med. 2010;38(4Suppl):74–90. DOI: 10.1097/CCM.0b013e3181cc5373Napolitano L.M., Park P.K., Raghavendran K., Bartlett R.H. Nonventilatory strategies for patients with life-threatening 2009 А/H1N1 influenza and severe respiratory failure. Crit Care Med. 2010;38(4Suppl):74–90. DOI: 10.1097/CCM.0b013e3181cc5373Novak J. Сурфактант-терапия ОРДС на фоне гриппа А/H1N1. В кн.: 14-я Всерос. конф. с междунар. участием «Жизнеобеспечение при критических состояниях». М.; 2012.Novak J. Surfactant treatment for А/H1N1 induces ARDS. In: 14th AllRussian Conference with International Participation on Life Support in Critical Conditions. Moscow; 2012 (In Russ.).Алексеев А.М., Шупинский О.В., Храпов К.Н. Интенсивная терапия больных с тяжелым течением гриппа A (H1N1), осложненного пневмонией. Вестник анестезиологии и реаниматологии. 2009;6(6):35–9.Alekseyev A.M., Shupinsky O.V., Khrapov K.N. Intensive therapy in patients with severe influenza A(H1N1) complicated by pneumonia. Messenger of anesthesiology and resuscitation. 2009;6(6):35–9 (In Russ.).Алексеев А.М., Яковлев А.А., Швечкова М.В., Сейлиев А.А., Волчков В.А., Розенберг О.А. Сурфактант-терапия пневмонии и ОРДС, ассоциированных с вирусом A/H1N1. Забайкальский медицинский журнал. 2011;(1): 23–7.Alekseyev A.M., Yakovlev A.A., Shvechkova M.V., Seiliev A.A., Volchkov V.A., Rozenberg A.O. Surfactant therapy for A/H1N1 virusassociated pneumonia and ARDS. Zabaikalskiy Meditsinskiy Zhurnal. 2011;(1):23–7 (In Russ.).Kesecioglu J., Beale R., Stewart T.E., Findlay G.P., Rouby J.J., Holzapfel L., et al. Exogenous natural surfactant for treatment of acute lung injury and the acute respiratory distress syndrome. Am J Respir Crit Care Med. 2009;180(10):989–94. DOI: 10.1164/rccm.200812-1955OCKesecioglu J., Beale R., Stewart T.E., Findlay G.P., Rouby J.J., Holzapfel L., et al. Exogenous natural surfactant for treatment of acute lung injury and the acute respiratory distress syndrome. Am J Respir Crit Care Med. 2009;180(10):989–94. DOI: 10.1164/rccm.200812-1955OCGünther A., Schmidt R., Harodt J., Schmehl T., Walmrath D., Ruppert C., et al. Bronchoscopic administration of bovine natural surfactant in ARDS and septic shock: impact of biophysical and biochemical surfactant properties. Eur Respir J. 2002;19(5):797–804. PMID: 12030716Günther A., Schmidt R., Harodt J., Schmehl T., Walmrath D., Ruppert C., et al. Bronchoscopic administration of bovine natural surfactant in ARDS and septic shock: impact of biophysical and biochemical surfactant properties. Eur Respir J. 2002;19(5):797–804. PMID: 12030716Walmrath D., Grimminger F., Pappert D., Knothe C., Obertacke U., Benzing A., et al. Bronchoscopic administration of bovine natural surfactant in ARDS and septic shock: impact on gas exchange and haemodynamics. Eur Respir J. 2002;19(5):805–10. DOI: 10.1183/09031936.02.00243402Walmrath D., Grimminger F., Pappert D., Knothe C., Obertacke U., Benzing A., et al. Bronchoscopic administration of bovine natural surfactant in ARDS and septic shock: impact on gas exchange and haemodynamics. Eur Respir J. 2002;19(5):805–10. DOI: 10.1183/09031936.02.00243402Willson D.F., Truwit J.D., Conaway M.R., Traul C.S., Egan E.E., Egan Edmund E. The adult calfactant in acute respiratory distress syndrome trial. Chest. 2015;148(2):356–64. DOI: 10.1378/chest.14-1139Willson D.F., Truwit J.D., Conaway M.R., Traul C.S., Egan E.E., Egan Edmund E. The adult calfactant in acute respiratory distress syndrome trial. Chest. 2015;148(2):356–64. DOI: 10.1378/chest.14-1139Баутин А.Е., Солнцев В.Н., Наумов А.Б., Гарифзянов А.Ф., Валькович А.А., Осовских В.В. и др. Изменение проницаемости альвеолокапиллярной мембраны и состояния комплекса легочного сурфактанта во время операций на сердце и аорте. Вестник анестезиологии и реаниматологии. 2010;7(5):11–7.Bautin A.E., Solntsev V.N., Naumov A.B., Garifzyanov A.F., Valkovich A.A., Osovskikh V.V., et al. Change in alveolar capillary membrane permeability and in the state of a lung surfactant complex during operations on the heart and aorta. Messenger of anesthesiology and resuscitation. 2010;7(5):11–7 (In Russ.).Oulton M., Fraser M., Dolphin M., Yoon R., Faulkner G. Quantification of surfactant pool sizes in rabbit lung during perinatal development. J Lipid Res.1986;27:602–12. PMID: 3755745Oulton M., Fraser M., Dolphin M., Yoon R., Faulkner G. Quantification of surfactant pool sizes in rabbit lung during perinatal development. J Lipid Res.1986;27:602–12. PMID: 3755745Розенберг О.А., Данилов Л.Н., Волчков В.А., Лебедева Е.С., Дубровская В.Ф., Валькович А.А. Фармакологические свойства и терапевтическая активность отечественных препаратов легочного сурфактанта. Бюллетень экспериментальной биологии и медицины. 1998;126(10):455–8.Rozenberg O.A., Danilov L.N., Volchkov V.A., Lebedeva E.S., Dubrovskaya V.F., Valkovich A.A., et al. Pharmacological properties and therapeutic effi acy of the domestic preparations of lung surfactants. Bulletin of Experimental Biology and Medicine. 1998;126(10):455–8 (In Russ.).Розенберг О.А., Сейлиев А.А., Гранов Д.А., Волчков В.А. Способ получения сурфактанта из легких крупного рогатого скота: пат. 2198670 РФ, 2002.Rozenberg O.A., Sejliev A.A., Granov D.A., Volchkov V.A. The method of obtaining surfactant from cattle. Russian Federation Patent RU 2198670; Fev. 19, 2002 (In Russ.).Grotberg J.B., Filoche M., Willson D.F., Raghavendran K., Notter R.H. Did reduced alveolar delivery of surfactant contribute to negative results in adults with acute respiratory distress syndrome? Am J Respir Crit Care Med. 2017;195(4):538–40. DOI: 10.1164/rccm.201607-1401LEGrotberg J.B., Filoche M., Willson D.F., Raghavendran K., Notter R.H. Did reduced alveolar delivery of surfactant contribute to negative results in adults with acute respiratory distress syndrome? Am J Respir Crit Care Med. 2017;195(4):538–40. DOI: 10.1164/rccm.201607-1401LERosenberg O.A., Bautin A.E., Seiliev A.A. Late start of surfactant therapy and surfactant drug composition as major causes of failure of phase III multi-center clinical trials of surfactant therapy in adults with ARDS. Int J Biomed. 2018;8(3):233–4. DOI: 10.21103/Article8(3)_LexRosenberg O.A., Bautin A.E., Seiliev A.A. Late start of surfactant therapy and surfactant drug composition as major causes of failure of phase III multi-center clinical trials of surfactant therapy in adults with ARDS. Int J Biomed. 2018;8(3):233–4. DOI: 10.21103/Article8(3)_LexKim H.C., Won Y.Y. Clinical, technological, and economic issues associated with developing new lung surfactant therapeutics. Biotech Adv. 2018;36(4):1185–93. DOI: 10.1016/j.biotechadv.2018.03Kim H.C., Won Y.Y. Clinical, technological, and economic issues associated with developing new lung surfactant therapeutics. Biotech Adv. 2018;36(4):1185–93. DOI: 10.1016/j.biotechadv.2018.03Yong-Sung Choi, Sung-Hoon Chung, Chong-Woo Bae. A combination of short and simple surfactant protein B and C analogues as a new synthetic surfactant: in vitro and animal experiments. Yonsei Med J. 2017;58(4):823–8. DOI: 10.3349/ymj.2017.58.4.823Yong-Sung Choi, Sung-Hoon Chung, Chong-Woo Bae A combination of short and simple surfactant protein B and C analogues as a new synthetic surfactant: in vitro and animal experiments. Yonsei Med J. 2017;58(4):823–8. DOI: 10.3349/ymj.2017.58.4.823Sweet D.G., Turner M.A., Straňák Z., Plavka R., Pau C., Stenson Ben J., et al. A first-in-human clinical study of a new SP-B and SP-C enriched synthetic surfactant (CHF5633) in preterm babies with respiratory distress syndrome. Arch Dis Child Fetal Neonatal Ed. 2017;102(6):497– 503. DOI: 10.1136/archdischild-2017-312722Sweet D.G., Turner M.A., Straňák Z., Plavka R., Pau C., Stenson Ben J., et al. A first-in-human clinical study of a new SP-B and SP-C enriched synthetic surfactant (CHF5633) in preterm babies with respiratory distress syndrome. Arch Dis Child Fetal Neonatal Ed. 2017;102(6):497– 503. DOI: 10.1136/archdischild-2017-312722Walther F.J., Gupta M., Lipp M.M., Chan H., Krzewick J., Gordon L.M., et al. Aerosol delivery of dry powder synthetic lung surfactant to surfactantdefi t rabbits and preterm lambs on non-invasive respiratory support. Gates Open Research. 2019;3:6. DOI: 10.12688/gatesopenres.12899.1Walther F.J., Gupta M., Lipp M.M., Chan H., Krzewick J., Gordon L.M., et al. Aerosol delivery of dry powder synthetic lung surfactant to surfactant-deficient rabbits and preterm lambs on non-invasive respiratory support. Gates Open Research. 2019;3:6. DOI: 10.12688/gatesopenres.12899.1

The authors declare that there are no conflicts of interest present.