SURFACTANT REPLACEMENT THERAPY FOR SEVERE 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 in spiratory oxygen concentration Exogenous surfactant, a well establishe d treatment in premature newborns with neonatal respiratory distress s yndrome has only been occasionally evaluated in adult respiratory dist ress syndrome. Case report.- A 3 year-old child suffered from adult re spiratory distress secondary to respiratory syncytial virus infection. Both mechanical ventilation and inhaled nitric oxide failed to improv e the respiratory distress. Two doses of intratracheal surfactant appl ication immediately improved pulmonary functions, transiently after th e first instillation on day 13 and definitely after the second one, on day 16. Conclusion.- Exogenous surfactant appeared to be useful for t he survival of our patient but prospective evaluation of this treatmen t in adult respiratory distress syndrome is needed.