Calf's lung surfactant extract in acute hypoxemic respiratory failure in children.
OBJECTIVE
Open-label trial of the safety and short-term efficacy of calf's lung surfactant in pediatric respiratory failure.


METHODS
Multi-institutional, uncontrolled, observational trial.


METHODS
Six pediatric intensive care units of tertiary medical centers.


METHODS
Twenty-nine children with acute hypoxemic respiratory failure, characterized by diffuse, bilateral, pulmonary infiltrates, need for ventilator support, and an oxygenation index of > or = 7.


METHODS
Up to four doses of intratracheal surfactant (80 mL/m2).


RESULTS
Ventilator parameters, arterial blood gases, and derived oxygenation and ventilation indices were recorded before, and at intervals after, surfactant administration. Complications and outcome measures were also noted. There was immediate improvement in oxygenation and moderation of ventilator support associated with surfactant administration in 24 of 29 patients. A modest but statistically insignificant effect was seen with subsequent doses. The only complications occurred in three patients who developed airleaks, two of which were coincident with surfactant administration. The overall mortality rate was 14%, which compares favorably with other published series.


CONCLUSIONS
Administration of calf's lung surfactant appears to be safe and is associated with rapid improvement in oxygenation and moderation of ventilator support in children with acute hypoxemic respiratory failure. These results set the stage for a randomized, controlled study.
Willson
D F
DF
Department of Pediatrics, Children's Medical Center, University of Virginia, Charlottesville, USA.
Jiao
J H
JH
Bauman
L A
LA
Zaritsky
A
A
Craft
H
H
Dockery
K
K
Conrad
D
D
Dalton
H
H
D000208:Acute Disease; D000293:Adolescent; D000818:Animals; D002417:Cattle; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D011446:Prospective Studies; D011663:Pulmonary Surfactants / Q000627:therapeutic use*; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000188:drug therapy* / Q000628:therapy; D012131:Respiratory Insufficiency / Q000188:drug therapy* / Q000401:mortality / Q000628:therapy; D016896:Treatment Outcome
D011663:Pulmonary Surfactants