Surfactant replacement therapy in RSV-induced acute respiratory distress syndrome (ARDS).
Acute respiratory distress syndrome (ARDS) associated with severe respiratory syncytial virus infection is rare. We report a 5-month-old Indian girl who was admitted to our intensive care ward with severe respiratory failure who fulfilled the criteria for ARDS using both Murray's Lung Injury Score of > 2.5 and the American-European Consensus Conference definition for ARDS. She developed diffuse bilateral alveolar infiltrates, severe hypoxaemia (PaO2/FiO2 < 100) and required high PEEP (> 15 cm H2O) 24 hours after admission. RSV was isolated from her nasopharyngeal secretion. She also had clinical features suggestive of a primary immunodeficiency and had laboratory evidence of combined T and B cell defect. There was unsustained clinical improvement with a dose of surfactant administered at 36 hours of PICU stay, and she continued to deteriorate and succumbed after 19 days in the PICU.
Department of Paediatrics, University Hospital, Kuala Lumpur, Malaysia.
A Y
AY
Goh
P W
PW
Chan
M
M
Roziah
D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011663:Pulmonary Surfactants / Q000627:therapeutic use*; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis / Q000628:therapy* / Q000821:virology*; D018357:Respiratory Syncytial Virus Infections / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*
D011663:Pulmonary Surfactants