medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-115medsovet-9207Research ArticleРАЦИОНАЛЬНАЯ ФАРМАКОТЕРАПИЯRATIONAL PHARMACOTHERAPYРоль экзогенного сурфактанта в лечении респираторных вирусных инфекцийThe role of exogenous surfactant in the treatment of respiratory viral infectionshttps://orcid.org/0000-0002-5536-9388ЧикинаС. Ю.ChikinaS. Yu.

Чикина Светлана Юрьевна, к.м.н., доцент кафедры пульмонологии, Институт клинической медицины имени Н.В. Склифосовского

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Svetlana Yu. Chikina, Cand. Sci. (Med.), Associate Professor

8, Bldg. 2, Trubetskaya St., Moscow, 119991

chikina_s_yu@staff.sechenov.ruПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian Federation20252206202509169172Copyright © Чикина С.Ю., 20252025Чикина С.Ю.Chikina S.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/9207

Легочный сурфактант представляет собой сложное вещество с высокой поверхностной активностью, которое предотвращает коллапс альвеол в конце выдоха, стабилизируя объем легких и газообмен. С этим свойством связаны попытки использовать препараты сурфактанта в клинической практике лечения острого респираторного дистресс-синдрома (ОРДС) взрослых и при тяжелых вирусных и бактериальных пневмониях. В данном обзоре литературы рассматриваются теоретические и практические аспекты применения сурфактанта у взрослых. В отдельных публикациях показано, что введение экзогенного сурфактанта в дыхательные пути позволяет повлиять на летальность пациентов с ОРДС, сократить сроки искусственной вентиляции легких и пребывания в стационаре. Большинство исследований относятся к ОРДС, связанному с новой коронавирусной инфекцией COVID-19, однако отдельные исследования рассматривают тяжелую пневмонию на фоне инфекции гриппа, респираторно-синцитиального вируса, а также вопросы улучшения доставки лекарственных препаратов, в первую очередь антибиотиков, в легочную ткань при инфекционной пневмонии. Опубликованные в настоящее время данные не позволяют четко определить место экзогенного сурфактанта в лечении этих заболеваний и состояний. Требуются дальнейшие клинические исследования эффективности экзогенного сурфактанта при тяжелых поражениях легочной ткани.

Pulmonary surfactant is a complex substance with high surface activity that prevents alveoli collapse at the end of expiration and, therefore, stabilizes the lung volume and the gas exchange. These properties of surfactant opened the way for its investigation in the respiratory distress syndrome of newborn and the acute respiratory distress syndrome (ARDS) in adults including patients with severe virus-associated and bacterial pneumonias. This paper is a review of published laboratory data and clinical findings on the efficacy of surfactant in adults. Several authors demonstrated that exogenous surfactant could improve mortality in patients with ARDS, reduce the need in mechanical ventilation and a length of hospitalization in general. Most clinical trials of surfactant were related to the novel coronavirus infection COVID-19, but several papers included patient with severe pneumonia associated with influenza or respiratory syncytial virus. Moreover, surfactant could be useful for better delivery of pharmacological agents, including antibiotics, in the distal airways and the lung tissue in patients with bacterial pneumonia. Unfortunately, current findings are scarce to certainly detecting a role of exogenous surfactant in the management of such patients. Further studies of clinical efficacy of exogenous surfactant in severe lung injury are required.

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