title: Calf's lung surfactant extract in acute hypoxemic respiratory failure in children.
abstract: 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.
authors.affiliation: Department of Pediatrics, Children's Medical Center, University of Virginia, Charlottesville, USA.
authors.forename: D F
authors.initials: DF
authors.lastname: Willson
authors.forename: J H
authors.initials: JH
authors.lastname: Jiao
authors.forename: L A
authors.initials: LA
authors.lastname: Bauman
authors.forename: A
authors.initials: A
authors.lastname: Zaritsky
authors.forename: H
authors.initials: H
authors.lastname: Craft
authors.forename: K
authors.initials: K
authors.lastname: Dockery
authors.forename: D
authors.initials: D
authors.lastname: Conrad
authors.forename: H
authors.initials: H
authors.lastname: Dalton
mesh_terms: 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
chemical_list: D011663:Pulmonary Surfactants