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

Andrea Wolfler, Marco Piastra, Angela Amigoni, Pierantonio Santuz, Eloisa Gitto, Emanuele Rossetti, Carmine Tinelli, Cinzia Montani, Fabio Savron, Simone Pizzi, Luigia D'amato, Maria Cristina Mondardini, Giorgio Conti, Annalisa De Silvestri

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BACKGROUND: 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. METHODS: 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. RESULTS: 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)
Original languageEnglish
Pages (from-to)203
Number of pages1
JournalBMC Pediatrics
Issue number1
Publication statusPublished - Jun 18 2019


  • Infants
  • Pediatric intensive care unit
  • Poractant
  • Surfactant
  • pARDS


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