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Updated: Jul 14, 2026

Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome (ARDS)
06:22

Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome (ARDS)

Published on: April 7, 2021

Surfactant therapy for acute respiratory failure in children: a systematic review and meta-analysis

Mark Duffett1, Karen Choong, Vivian Ng

  • 1Department of Critical Care, McMaster Children's Hospital, 1200 Main St, W, Hamilton, Ontario L8S 4J9, Canada. duffett@hhsc.ca

Critical Care (London, England)
|June 19, 2007
PubMed

Insights

Exogenous pulmonary surfactant reduces mortality in children with acute respiratory failure. This treatment also increases ventilator-free days and shortens the duration of mechanical ventilation, with no serious adverse events reported.

Area of Science:

  • Pediatric Critical Care
  • Respiratory Medicine
  • Neonatal and Pediatric Research

Background:

  • Acute respiratory failure in children is a critical condition.
  • The efficacy and safety of exogenous surfactant therapy for pediatric acute respiratory failure remain unclear.
  • This systematic review investigates the impact of exogenous pulmonary surfactant on mortality in mechanically ventilated children.

Purpose of the Study:

  • To systematically review the effect of exogenous pulmonary surfactant on all-cause mortality in children with acute respiratory failure requiring mechanical ventilation.

Main Methods:

  • A comprehensive search of multiple databases (MEDLINE, EMBASE, CINAHL, Ovid Healthstar), trial registries, and reference lists was conducted.
  • Prospective, randomized, controlled trials involving intubated, mechanically ventilated children with acute respiratory failure were included, excluding neonates and asthma patients.
  • Data extraction and quality assessment were performed independently by two reviewers, with quantitative pooling using a random-effects model where appropriate.

Main Results:

  • Six trials involving 314 patients were analyzed.
  • Exogenous surfactant significantly reduced all-cause mortality (RR = 0.7; 95% CI, 0.4 to 0.97; P = 0.04).
  • Surfactant therapy was associated with increased ventilator-free days (WMD = 2.5 days; 95% CI, 0.3 to 4.6 days; P = 0.02) and reduced duration of ventilation (WMD = 2.3 days; 95% CI, 0.1 to 4.4 days; P = 0.04).

Conclusions:

  • Exogenous surfactant administration decreases mortality in pediatric patients with acute respiratory failure.
  • The use of surfactant is linked to improved outcomes, including more ventilator-free days and shorter ventilation duration.
  • No serious adverse events were reported, suggesting a favorable safety profile for this intervention in the studied pediatric population.
Abstract

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