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.
Goh
A Y
AY
Department of Paediatrics, University Hospital, Kuala Lumpur, Malaysia.
Chan
P W
PW
Roziah
M
M
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