Expert: Dr Ian Jackson - please note UK based - 3/1/2008

Question
My brother was diagnosed with aplastic anemia two months ago since then he has had a chemotherapy and then a bone marrow transplant which has been a success,but since then there has been complications with his lungs.the doctors say his lung x-ray looks really bad he had a massive bleed into his lungs because his platelets were so low.He was put onto a ventilator a day after he was put into ITU(that was 12 days ago)and he is still on it.He is stable but a bit confused.The doctor has described his lungs as brittle and he has secretions in them as well.Is there anything they can do for his lungs especially the brittle part?I have heard of surfactants,could you tell me what they are and if they could help him? many thanks.

Answer
Hi Honor
I am sorry to hear about your brother. He is suffering from a severe illness and the lung complications do happen and are very serious when they occcur. This must have been very difficult for you and your family. I am sure the intensivists are trying everything they can to support your brother through this problem. Indeed given the seriousness of the situation I would guess that he is in excellent hands to have got this far. Surfactant is an agent produced by cells in our lungs that lowers the surface tension of the fluid that moistens the air sacs (alveoli) in our lungs.
This helps stop the surface tension of the fluid pulling our air sacs closed and so allows us to maximise the surface area we have for exchanging oxygen and carbon dioxide.
Intensive care is not my area of expertise but I have not seen my Intensivist colleagues use surfactant in this situation in this situation in the UK. I'm afraid what is needed is for your brother to be continue to be supported while his body tries to repair his lungs.
I hope that he continues to improve.
Kind regards
Dr Ian Jackson