Table 2.

Results from trials of the efficacy of exogenous surfactant in mechanically ventilated children with viral lower respiratory tract disease

	Reference
	[26]	[27]	[28]
Study population	20 children with bronchiolitis	40 children with bronchiolitis	19 infants with bronchiolitis
% RSV+	20%	100%	100%
Surfactant preparation	Curosurf	Curosurf	Survanta
Dosage	50 mg/kg once	50 mg/kg once	100 mg/kg twice
Time of administration	Unknown	Unknown	t = 0 and t = 24 hours after PICU admission
Inclusion criteria	PaO2/FiO2 ratio <150 PIP >35 cmH2O	PaO2/FiO2 <150 PIP >35 cmH2O	Oxygenation index > 5 Ventilation index > 20
Clinical phenotype	Restrictive	Restrictive	Obstructive
Ventilatory strategy
Mode of ventilation	Volume control	Volume control	Pressure control
Permissive hypercapnia (pH > 7.25)	No	Yes	Yes
Permissive hypoxaemia (PaO2 >60 mmHg or SaO2 >88%)	No	Yes	Yes
Manual ventilation before surfactant administration	Yes	Yes	No
Main outcome findings
Duration of mechanical ventilation	Reduced	Reduced	Tendency toward reductiona
Duration of PICU stay	Reduced	Reduced	Tendency toward reductiona
Oxygenation	Increased PaO2/FiO2	Increased PaO2/FiO2	Decreased oxygenation index and alveolar-arterial oxygen gradient

^aStudy was not powered to detect significant differences. FiO₂, fractional inspired oxygen; PaO₂, arterial oxygen tension; PICU, paediatric intensive care unit; PIP, positive inspiratory pressure; RSV, respiratory syncytial virus; SaO₂, arterial oxygen saturation.