Intraoperative early prevention of acute respiratory distress syndrome in thoracic aortic reconstruction: a case report

Acute respiratory distress syndrome (ARDS) remains one of the most common and severe complications in patients undergoing thoracic aortic reconstructive surgery under conditions of cardiopulmonary bypass, hypothermia, and circulatory arrest. The development of ARDS requires prolonged respiratory support, prolongs the length of stay in the intensive care unit, and significantly increases the risk of pneumonia, sepsis, and multiple organ failure. We present a clinical case of successful early prophylactic administration of exogenous surfactant (Surfactant-BL) to a 62-year-old patient with an aortic arch aneurysm and multivessel coronary artery disease who underwent thoracic aortic reconstruction using the Frozen Elephant Trunk technique in combination with coronary artery bypass grafting. Given the high risk of developing ARDS, early intraoperative prophylaxis was initiated after the initiation of cardiopulmonary bypass and before circulatory arrest, and continued in the early postoperative period. No clinical or radiographic signs of ARDS were observed in the early postoperative period. After transfer to a specialized cardiac surgery unit, no signs of respiratory failure were observed throughout the hospitalization.

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