Article Data

  • Views 1392
  • Dowloads 121

Original Research

Open Access

Diluted porcine surfactant  lung lavages in children with severe ARDS 


1,Pediatric Intensive Care Unit Emergency Department A. Gemelli Hospital of Rome

DOI: 10.22514/SV42.102009.3 Vol.4,Issue 2,October 2009 pp.16-19

Published: 28 October 2009

*Corresponding Author(s): LUCA TORTOROLO E-mail:


Acute respiratory distress syndrome (ARDS) is characterized by damage to the arteriolar-capillary endothelium and alveolar epithelium that leads to surfactant deficiency and atelectasis. Alveolar collapse and pulmonary edema will further induce surfactant inactivation. Surfactant supplementation has been suggested but results are unpredictable. Poor response may be due to inhibition of administered surfactant by plasma components filling the alveolar space, severity of lung injury, time of surfactant application and inadequate dose. We report the course of gas exchange and pulmonary mechanics after insti-llation of surfactant in 14 children (3 months-7 years) with severe ARDS, defined as an oxygenation index (OI) > 30 and a 

partial pressure of oxygen/ fraction of Inspired oxygen (PaO2/FiO2) <150 . We used a diluted concentration of Curosurf (8 mg/ml) divided into 4 aliquots, for a total dose of 25 mg/kg. An additional aliquot was used for bronchoalveolar lavage 

before surfactant treatment.  

 All children showed a dramatic response to surfactant with rapid and progressive increase in compliance and improve-ment of all respiratory mechanics. Mechanical ventilation settings were rapidly reduced and gas exchange improved with 

a PaO2/FiO2 >200 for more than 12 hours.

Diluted surfactant lung lavages were able to increase blood gas exchange in all our patients despite previously severe gas 

exchange impairment.


ARDS, pulmonary surfac-tant, bronchoalveolar lavages, child

Cite and Share

LUCA TORTOROLO,ANTONIO CHIARETTI,SILVIA PULITANÒ,ORAZIO GENOVESE,GIORGIO CONTI. Diluted porcine surfactant lung lavages in children with severe ARDS . Signa Vitae. 2009. 4(2);16-19.


1. Bush A. Up Date in pediatric lung disease 2008. Am J Respir Crit Care Med 2009;179:637-49.

2. Dahlem P, van Aalderen WM, Bos AP. Pediatric acute lung injury. Pediatric Respir Rev 2007;8:348-62.

3. Willson DF, Chess PR, Notter RH. Surfactant for pediatric acute lung injury. Pediatric Clin North Am 2008;55:545-75.

4. Marraro GA, Lucchetti M, Spada C, Galassini E, Giossi M, Piero AM. Selective medicated (normal saline and exogenous surfactant) bron-choalveolar lavage in severe aspiration syndrome in children. Pediatr Crit Care Med 2007;8:505-6.

5. Luchetti M, Ferrero F, Gallini C, Natale A, Pigna A, Tortorolo L, et al. Multicenter, randomized, controller study of porcine .surfactant in severe respiratory syncitial virus-induced respiratory failure. Pediatr Crit Care Med 2002;3:261-6.

6. Meister J, Venkataraman B, Ramirez M, Uyehara FT, Killeen J, Ku T, et al. Lavage administration of diluted surfactant in a piglet model of meconium aspiration. Lung 2004;182:227-40.

7. Gommers D, Eijking P, So Kl, van’t Veen A, Lachmann B. Bronchoalveolar lavage with a diluted surfactant suspension prior to surfactant instillation improves the effectiveness of surfactant therapy in experimental acute respiratory distress syndrome (ARDS). Intensive Care Med 1998;24:494-500.

8. Cochrane G, Revak S. Surfactant lavage treatment in a model of respiratory distress syndrome. Chest 1999;116:85-6.

9. Duffett M, Choong K, Ng V, Randolph A, Cook DJ. Surfactant therapy for acute respiratory failure in children: a systematic review and meta-analysis. Crit Care 2007;11:66.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

Index Copernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 1.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time