WITHDRAWN. Surfactant therapy for bronchiolitis in critically ill infants

Area of Science:

• Pediatric critical care medicine
• Respiratory medicine
• Neonatology

Background:

• Viral bronchiolitis is a leading cause of respiratory failure in infants, frequently requiring intensive care unit (ICU) admission.
• Current treatment relies solely on supportive care, lacking specific evidence-based therapies.
• Surfactant, a key component of lung function, is being investigated for its potential role in bronchiolitis treatment due to observed alterations in its composition and potential immunomodulatory effects.

Purpose of the Study:

• To evaluate the effectiveness of exogenous surfactant administration in treating viral bronchiolitis in mechanically ventilated infants and children.

Main Methods:

• A systematic review of randomized controlled trials (RCTs) was conducted.
• Searches included the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and EMBASE databases.
• Data extraction and quality assessment were performed independently by two authors.

Main Results:

• Three RCTs involving 79 patients met the inclusion criteria.
• No significant mortality or adverse effects were reported with surfactant use.
• Surfactant administration showed a trend towards reduced mechanical ventilation duration (2.6 days) and ICU length of stay (3.3 days), though not statistically significant in all analyses.
• Pooled analysis of two studies indicated a significant reduction in ventilator days (1.21 days) and ICU stay (1.81 days).

Conclusions:

• The available evidence is insufficient to reliably determine the efficacy of exogenous surfactant for treating bronchiolitis in mechanically ventilated children.
• Further adequately powered studies are needed to address optimal surfactant preparations, dosing, administration intervals, and the influence of ventilator strategies.