. .

. () - , -
, - -
.
- , . .
.
-
: - , -
- , - ,
. .
- : , , , -
. . .

ON THE USE OF PULMONARY SURFACTANT IN CONDITIONS

WITHOUT ITS PRIMARY DEFICIENCY
S. Jargin
Annotation. Pulmonary surfactant (Sf) reduces surface tension
thus facilitating spreading of collapsed alveoli. Sf preparations are
used in respiratory distress syndrome of the newborn a condition
with a primary deficiency of Sf. It was reported in some publications
about successful use of exogenous Sf in conditions without its
primary deficiency: acute respiratory distress syndrome of children
and adults, tuberculosis and others. Bronchoscopy was used in
some studies as a delivery method. A brief review of literature on
this topic is presented. It is concluded that some published data
are unconvincing and not generally confirmed by the international
literature. Conflicts of interest cannot always be excluded. Further
studies using different experimental models, adequately planned
and performed to be reproducible, are necessary.
Keywords: surfactant, ARDS, tuberculosis, bronchoscopy.

() -
,
.
[9, 1220]. -

[21, 22],
-- - , ,
, [15, 23].
. - , , -
-
: [24] [25].
- () , -
[13], - [26].
. , -

, - -
, - [27];
[4, 5]. , - , -
, , . ,
BL -
- , -
6080% 1520% [6]. -.
,
,
M. tuberculosis [7, 8]. - : -
-
(ALI) [9,
10], [11, 12]. ,
,
-
[9, 13, 14] [15]. , -

- [28].

www.akvarel2002.ru 2 (54) 2017 69



. -
( ) 28.11.2009 24-5/10/2-9533,
. - - ,
- (H1N1), -BL
. - , , -
[29]. -
, ...
- [43].
, . , -
.
[26, 28]. - [44].
, -
- [4, 45].
. , -
, - , -
. , - [46].
, ,
- , -
-, - . ,
[29]. ,
-
[28], , -
, [47].
: - [48], -
- -
. -
[30]
[31]. -
- [48, 49], -
. - .
, , ,
[32], -, . -
-. - - - [4, 45] -
.
[4]. , - -
,
, - [4, 5, 45], -
- ,
[45]
. . -
- - , -
, - [50].
[33] [34] ,
[35] . - ,
- -
. [31] -
- .
; -
[31, 36]. , -
,
- , -
[37]. [3842] .
, -
, - , [51]. , -
- -
[40]. [41] ,
-
12 23 ; .

70 2 (54) 2017 www.akvarel2002.ru



1. . ., . ., . . . -BL -
- // . . . . 2002. 2. . 1823.
2. . ., . ., . . . . - -
// . . 2001. 5. . 3438.
3. . ., . ., . . . -
// 2195958, 2002.
4. . ., . ., . . . -
// . . . . 2006. 10. . 1217.
5. . ., . ., . . . // 2195313, 2002.
6. (2013). -BL. http://biosurf.ru/bl.htm (16.10.2016).
7. Chroneos Z. C., Midde K., Sever-Chroneos Z., Jagannath C. Pulmonary surfactant and tuberculosis // Tuberculosis (Edinb). 2009.
V.89. Suppl. 1. P. 1014.
8. Stoops J. K., Arora R., Armitage L. et al. Certain surfactants show promise in the therapy of pulmonary tuberculosis // In vivo. 2010.
V.24. P. 687694.
9. Kesecioglu J., Haitsma J. J. Surfactant therapy in adults with acute lung injury/acute respiratory distress syndrome // Curr. Opin. Crit. Care.
2006. V.12. P. 5560.
10. Prabhakaran P. Acute respiratory distress syndrome // Indian Pediatr. 2010. V.47. P. 861868.
11. Willson D. F., Thomas N. J., Markovitz B. P. et al. Effect of exogenous surfactant (calfactant) in pediatric acute lung injury: a randomized
controlled trial // JAMA. 2005. V.293. P. 470476.
12. Willson D. F., Notter R. H. The future of exogenous surfactant therapy // Respir. Care. 2011. V.56. P. 13691388.
13. Spragg R. G., Lewis J. F., Walmrath H. D. et al. Effect of recombinant surfactant protein C-based surfactant on the acute respiratory distress
syndrome // N. Engl. J. Med. 2004. V.351. P. 884892.
14. . ., . . -: -
// . . 2014. 11. . 115122.
15. Davidson W. J., Dorscheid D., Spragg R. et al. Exogenous pulmonary surfactant for the treatment of adult patients with acute respiratory
distress syndrome: results of a meta-analysis // Crit. Care. 2006. V.10. P. 41.
16. Anzueto A., Baughman R. P., Guntupalli K. K. et al. Aerosolized surfactant in adults with sepsis-induced acute respiratory distress syndrome.
Exosurf Acute Respiratory Distress Syndrome Sepsis Study Group // N. Engl. J. Med. 1996. V.334. P. 14171421.
17. Bernard G. R. Innovative therapy. In: Russel J. A., Walley K. R. (editors) Acute respiratory distress syndrome. Cambridge: University
Press, 1999. P. 233250.
18. Adhikari N. K. J., Burns K. E. A., Meade M. O., Ratnapalan M. Pharmacologic therapies for adults with acute lung injury and acute
respiratory distress syndrome // Cochrane Libr. 2010. doi: 10.1002/14651858.CD004477.pub2.
19. Zhang L. N., Sun J. P., Xue X. Y., Wang J. X. Exogenous pulmonary surfactant for acute respiratory distress syndrome in adults: Asystematic
review and meta-analysis // Exp. Ther. Med. 2013. V.5. P. 237442.
20. Filoche M., Tai C. F., Grotberg J. B. Three-dimensional model of surfactant replacement therapy // Proc. Natl. Acad. Sci. USA. 2015.
V.112. P. 92879292.
21. Walmrath D., Gunther A., Ghofrani H. A. et al. Bronchoscopic surfactant administration in patients with severe adult respiratory distress
syndrome and sepsis // Am. J. Respir. Crit. Care Med. 1996. V.154. P. 5762.
22. Lewis J. F., Jobe A. H. Surfactant and the adult respiratory distress syndrome // Am. ReV.Respir. Dis. 1993. V.147. P. 218233.
23. Stevens T. P., Sinkin R. A. Surfactant replacement therapy // Chest. 2007. V.131. P. 15771582.
24. Matthay M. A., Zemans R. L. The acute respiratory distress syndrome: pathogenesis and treatment // Annu. Rev.Pathol. 2011. V.6.
P. 147163.
25. Cortes I., Penuelas O., Esteban A. Acute respiratory distress syndrome: evaluation and management // Minerva Anestesiol. 2012.
V.78. P. 343357.
26. Im D., Shi W., Driscoll B. Pediatric acute respiratory distress syndrome: Fibrosis versus repair // Front. Pediatr. 2016. V.4. P. 28.
27. Taut F. J., Rippin G., Schenk P. et al. A Search for subgroups of patients with ARDS who may benefit from surfactant replacement therapy:
a pooled analysis of five studies with recombinant surfactant protein-C surfactant (Venticute) // Chest. 2008. V.134. P. 724732.
28. . ., . . - . .: -, 2016.
29. Cotran R. S., Kumar V., Robbins S. L. Robbins Pathologic Basis of Disease. Philadelphia: W. B. Saunders Co., 1994.
30. . ., . . // . -
. 2003. 3. . 2451.
31. . ., . ., . . . -
- // . 1998. 3. . 5155.
32. . ., . . // . . 1998. 5. . 4146.
33. Lachmann B. Animal models and clinical pilot studies of surfactant replacement in adult respiratory distress syndrome // Eur. Respir. J.
Suppl. 1989. V.3. P. 98103.
34. Huang Y. C., Caminiti S. P., Fawcett T. A. et al. Natural surfactant and hyperoxic lung injury in primates. I. Physiology and biochemistry //
J.Appl. Physiol. 1994. V.76. P. 9911001.
35. Feldbaum D. M., Wormuth D., Nieman G. F. et al. Exosurf treatment following wood smoke inhalation // Burns. 1993. V.19.
P.396400.
36. . . //
. ... .: . . . , 2005.
37. Jargin S. V.Surfactant therapy of pulmonary conditions excluding those with primary surfactant deficiency and bronchoscopy as delivery
method: an overview of Russian patents and publications // Recent Pat. Drug. Deliv.Formul. 2013. V.7. P. 134137.
38. . ., . ., . . . (-
BL) - // -, -
. . . . . , 1999. C. 169.
39. . ., . ., . . . - - // .
. 2001. 5. . 3438.
40. . ., . ., . ., . . -
// . . . . . .
2003. 2. . 7983.
41. . ., . ., . ., . . - -
// . . 2011. 3. . 4447.
42. . ., . . - - -
// . . 2005. 6. . 3841.
43. C-. P 003383/ 01230710. http://biosurf.
ru/documents/instrukcia.pdf (16.10.2016).
44. Jargin S. V.On the endoscopic methods used with questionable indications // J. Surgery. 2016. V.4. P. 6.
45. . ., . ., . ., . . . .: -
, 2013.
46. . ., . ., . . - -
// . . 2009. 1. . 7273.

www.akvarel2002.ru 2 (54) 2017 71



47. Jargin S. V.Re: Collaborative quality improvement to promote evidence based surfactant for preterm infants: a cluster randomized trial /
BMJ Rapid Response, 5 September 2013.
48. Davis J. M., Russ G. A., Metlay L. et al. Short-term distribution kinetics of intratracheally administered exogenous lung surfactant // Pediatr.
Res. 1992. V.31. P. 445450.
49. Espinosa F. F., Shapiro A. H., Fredberg J. J., Kamm R. D. Spreading of exogenous surfactant in an airway // J. Appl. Physiol. 1993.
V.75. P. 20282039.
50. Lee P., Mehta A. C., Mathur P. N. Management of complications from diagnostic and interventional bronchoscopy // Respirology. 2009.
V.14. P. 940953.
51. Potgieter L. N., McCracken M. D., Hopkins F. M. et al. Use of fiberoptic bronchoscopy in experimental production of bovine respiratory tract
disease // Am. J. Vet. Res. 1984. V.45. P. 10151019.

. . , , , .

,


. . , . . , . .
. -
- .
, : , ,
, , , .

THE FACTORS WHICH INFLUENCING THE COMMITMENT TO TREATMENT TB PATIENTS

S. Ryzhkov, L. Shovkun, O. Glebova
Annotation. The analysis of the social status of the contingents
of patients with active tuberculosis, influence of a migration flow
on tension of an epidemiological situation in the Rostov region, the
reasons of depression of commitment to treatment of TB patients are
presented in the article.
Keywords: tuberculosis, commitment to treatment, institutions of
Federal Penitentiary Service, arrived, migration.

-
() -
-
,
. -
, -
().
-
- . , ,
. ,
-
.
,
50 , ,
- - ,
. - :
, - 64%;
- - 36,9%;
( 30,4%;
2018 .). 16,1%;

9,8%;
-
, 3%.
,
, , -
-
(. 1). -
.
, (. 1).
3 -

40 - , - 10
. (. . 1).

72 2 (54) 2017 www.akvarel2002.ru