Mark Duffett, Karen Choong, Vivian Ng, Adrienne Randolph, Deborah J Cook
Exogenous surfactant is used to treat acute respiratory failure in children, although the benefits and harms in this setting are not clear. This systematic review assesses the effect of exogenous pulmonary surfactant on all-cause mortality in children mechanically ventilated for acute respiratory failure.
The authors searched databases, bibliographies of included trials and review articles, conference proceedings and trial registries; and included prospective, randomized, controlled trials of pulmonary surfactant that enrolled intubated and mechanically ventilated children with acute respiratory failure.
Six trials randomizing 314 patients were included. Surfactant reduced mortality (Relative Risk (RR) 0.7, 95% Confidence Interval (CI) 0.4 to 0.97, p=0.04). The results were that surfactant decreased mortality, was associated with more ventilator free days and shorter ventilation times (weighted mean difference 2.3 days, 95% CI 0.1 to 4.4 days, p=0.04).
Critical Care 2007, 11 (3) R66