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Open Badges Commentary

Surfactant for acute respiratory failure in children: where should it fit in our treatment algorithm?

Margrid Schindler

Author Affiliations

Paediatric Intensive Care Unit, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol BS2 8BJ, UK

Critical Care 2007, 11:148  doi:10.1186/cc5951

See related research by Duffet et al.,

Published: 19 July 2007


In a recent meta-analysis, surfactant administration in paediatric acute respiratory failure was associated with improved oxygenation, reduced mortality, increased ventilator-free days and reduced duration of ventilation. Surfactant is expensive, however, and its use involves installation of large volumes into the lungs, resulting in transient hypoxia and hypotension in some patients. Many questions also remain unanswered, such the as optimum dosage and the timing of administration of surfactant. The merits of surfactant administration should therefore still be decided on an individual case-by-case basis.