[Value of surfactant in the treatment of acute respiratory distress syndrome in a child].
BACKGROUND
Adult respiratory distress syndrome has a high mortality rate, despite treatment including mechanical ventilation with positive end-expiratory pressure, increase of the inspiratory time and high inspiratory oxygen concentration. Exogenous surfactant, a well established treatment in premature newborns with neonatal respiratory distress syndrome has only been occasionally evaluated in adult respiratory distress syndrome.


METHODS
A 3 year-old child suffered from adult respiratory distress secondary to respiratory syncytial virus infection. Both mechanical ventilation and inhaled nitric oxide failed to improve the respiratory distress. Two doses of intratracheal surfactant application immediately improved pulmonary functions, transiently after the first instillation on day 13 and definitely after the second one, on day 16.


CONCLUSIONS
Exogenous surfactant appeared to be useful for the survival of our patient but prospective evaluation of this treatment in adult respiratory distress syndrome is needed.
Fraisse
A
A
Département d'anesthésie-réanimation pédiatrique, hôpital de La Timone, Marseille, France.
Paut
O
O
Silicani
M A
MA
Viard
L
L
Camboulives
J
J
D000208:Acute Disease; D001688:Biological Products; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009569:Nitric Oxide / Q000627:therapeutic use; D010743:Phospholipids; D011663:Pulmonary Surfactants / Q000008:administration & dosage / Q000627:therapeutic use*; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D018357:Respiratory Syncytial Virus Infections / Q000150:complications; D014132:Trachea
D001688:Biological Products; D010743:Phospholipids; D011663:Pulmonary Surfactants; D009569:Nitric Oxide; C068291:poractant alfa
Intérêt du surfactant exogène dans le traitement du syndrome de détresse respiratoire aiguë de l'enfant.