A shared protocol for porcine surfactant use in pediatric acute respiratory distress syndrome: a feasibility study

Pediatric ARDS still represents a difficult challenge in Pediatric Intensive Care Units (PICU). Among different treatments proposed, exogenous surfactant showed conflicting results. Aim of this multicenter retrospective observational study was to evaluate whether poractant alfa use in pediatric ARDS...

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Bibliographic Details
Published in:BMC pediatrics 2019-06, Vol.19 (1), p.203-203, Article 203
Main Authors: Wolfler, Andrea, Piastra, Marco, Amigoni, Angela, Santuz, Pierantonio, Gitto, Eloisa, Rossetti, Emanuele, Tinelli, Carmine, Montani, Cinzia, Savron, Fabio, Pizzi, Simone, D'amato, Luigia, Mondardini, Maria Cristina, Conti, Giorgio, De Silvestri, Annalisa
Format: Article
Language:English
Subjects:
Age
Analysis
Blood gas analysis
Bronchiolitis
Calfactant
Care and treatment
Children
Comorbidity
Data collection
Drug dosages
Feasibility studies
Future predictions
Health aspects
Infants
Intensive care
Lucinactant
Medical research
Mortality
pARDS
Patient outcomes
Patients
Pediatric intensive care
Pediatric intensive care unit
Pediatrics
Pneumonia
Poractant
Recruitment
Respiratory distress syndrome
Respiratory insufficiency
Respiratory syncytial virus
Respiratory therapy
Septic shock
Shock
Substance abuse treatment
Surface active agents
Surfactant
Surfactants
Ventilators
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Summary:Pediatric ARDS still represents a difficult challenge in Pediatric Intensive Care Units (PICU). Among different treatments proposed, exogenous surfactant showed conflicting results. Aim of this multicenter retrospective observational study was to evaluate whether poractant alfa use in pediatric ARDS might improve gas exchange in children less than 2 years old, according to a shared protocol. The study was carried out in fourteen Italian PICUs after dissemination of a standardized protocol for surfactant administration within the Italian PICU network. The protocol provides the administration of surfactant (50 mg/kg) divided in two doses: the first dose is used as a bronchoalveolar lavage while the second as supplementation. Blood gas exchange variations before and after surfactant use were recorded. Sixty-nine children, age 0-24 months, affected by Acute Respiratory Distress Syndrome treated with exogenous porcine surfactant were enrolled. Data collection consisted of patient demographics, respiratory variables and arterial blood gas analysis. The most frequent reasons for PICU admission were acute respiratory failure, mainly bronchiolitis and pneumonia, and septic shock. Fifty-four children (78.3%) had severe ARDS (define by oxygen arterial pressure and inspired oxygen fraction ratio (P/F)
ISSN:1471-2431
1471-2431
DOI:10.1186/s12887-019-1579-3