Abstract
<title>Abstract</title> <p>Background One of the important causes of acute postoperative respiratory failure may be a decrease in the surface activity of interfacial surfactant located at the air/liquid interface and providing surface tension of alveoli and bronchioles .The main problem with the use of exogenous surfactant obtained from animals (calves, lambs, pigs, etc.) by lung flushing and synthetic surfactant is that in the treatment of acute respiratory failure there are not enough convincing good results in the treatment of severe patients. Exogenous surfactant does not correspond to human surfactant in its biochemical composition, adsorption, distribution, surface-active properties, and excretion period. Objectives To investigate the effects of autosurfactant therapy on respiratory mechanics and oxygenation in patients with acute postoperative respiratory failure. Methods The examination and treatment data of 27 patients, operated in the thoracic department were included in this study. Central form of cancer in stage II-III was detected in all 27 patients. In the postoperative period all patients had complications from the side of respiratory organs, disorders of tracheobronchial patency with hypoventilation of one or two lung lobes in 26 patients, atelectasis of a lobe in one patient .Pulmonary complians was reduced and amount 38,2 ± 0,2 ml/mbar on ventilator Blood oxygen saturation (SaO2) was reduced and was 93 ± 04%. Due to the severity of the condition caused by the development of respiratory failure, prolonged ventilation in PSV Bronchoalveolar flush was obtained from healthy subsegmental bronchi of the lung contralateral to the pathological process before surgery during fibrobronchoscopic examination of the patient in the amount of 40–50 ml. It was filtered through sterile gauze and centrifuged at low temperature for 10 minutes. Surface tension was checked on a Wilhelmi scale. Supernatant containing surfactant with good surfactant properties was used for therapy of acute postoperative respiratory failure, where the surface tension minimum was 24 ± 3.0 mN/m. The supernatant fluid in the amount of 10–15 ml was injected into the right or left main bronchus in the presence of hypoventilation and atelectasis of the damaged lung in a patient identified using a fiberoptic bronchoscope. Results After application of autosurfactant, there was an increase in respiratory volume by 10.3 ± 0.2% (p = 0.02), lung compliance by 21.4 ± 0.35% (p ˂0.05), SaO2 93 ± 0,4% to 97 ± 0,3%. There was no antigenic incompatibility of the thus obtained preparation with human surfactant, since this method is not organ and tissue transplantation. Conclusions The application of autosurfactant demonstrated significant clinical efficacy in improving pulmonary function for patients with acute postoperative faiulure. This innovative approach offers a promising therapeutic alternative for managing respiratory complications.</p>