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

Content Provider	Springer Nature : BioMed Central
Author	Duffett, Mark Choong, Karen Ng, Vivian Randolph, Adrienne Cook, Deborah J
Abstract	Introduction Exogenous surfactant is used to treat acute respiratory failure in children, although the benefits and harms in this setting are not clear. The objective of the present systematic review is to assess the effect of exogenous pulmonary surfactant on all-cause mortality in children mechanically ventilated for acute respiratory failure. Methods We searched the MEDLINE, EMBASE, CINAHL and Ovid Healthstar databases, the bibliographies of included trials and review articles, conference proceedings and trial registries. We included prospective, randomized, controlled trials of pulmonary surfactant that enrolled intubated and mechanically ventilated children with acute respiratory failure. We excluded trials that exclusively enrolled neonates or patients with asthma. Two reviewers independently rated trials for inclusion, extracted data and assessed the methodologic quality. We quantitatively pooled the results of trials, where suitable, using a random effects model. Results Six trials randomizing 314 patients were included. Surfactant use reduced mortality (relative risk = 0.7, 95% confidence interval = 0.4 to 0.97, P = 0.04), was associated with increased ventilator-free days (weighted mean difference = 2.5 days, 95% confidence interval = 0.3 to 4.6 days, P = 0.02) and reduced the duration of ventilation (weighted mean difference = 2.3 days, 95% confidence interval = 0.1 to 4.4 days, P = 0.04). Conclusion Surfactant use decreased mortality, was associated with more ventilator-free days and reduced the duration of ventilation. No serious adverse events were reported.
Related Links	https://ccforum.biomedcentral.com/counter/pdf/10.1186/cc5944.pdf
Ending Page	10
Page Count	10
Starting Page	1
File Format	HTM / HTML
ISSN	13648535
DOI	10.1186/cc5944
Journal	Critical Care
Issue Number	3
Volume Number	11
Language	English
Publisher	BioMed Central
Publisher Date	2007-06-15
Access Restriction	Open
Subject Keyword	Intensive Critical Care Medicine Emergency Medicine Mechanical Ventilation Respiratory Syncytial Virus Acute Lung Injury Acute Respiratory Failure Bronchiolitis
Content Type	Text
Resource Type	Article
Subject	Critical Care and Intensive Care Medicine
Journal Impact Factor	8.8/2023
5-Year Journal Impact Factor	10.4/2023

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