Surfactant in babies with severe bronchiolitis
| Citation | Study group | Study type (level of evidence) | Outcome | Key results | Comments |
|---|---|---|---|---|---|
| Tibby et al (2000) | 19 infants. 9 receiving 2 doses of surfactant with ventilation, 10 ventilation plus placebo | Randomised controlled trial (level 1b) | Ventilation index (VI) and oxygenation index (OI) up to 60 h | Improved OI at 60 h (p<0.01) and VI (p< 0.001) | Small study. Mean age of treated children 9 wk. Values for the changes in OI/VI not tabulated or given in the text |
| All RSV + cases | |||||
| Mean ventilation time | Surfactant v placebo: 126 v 170 h (p=0.4) | Blinding carried out. Method not stated | |||
| Randomisation method not clear | |||||
| Mean length of stay in PICU | Surfactant v placebo: 161 v 213 h (p=0.3) | Insufficient power to detect clinically significant changes in outcomes regarding ventilation times, etc | |||
| Luchetti et al (1998) | 20 children; 10 ventilated and given surfactant; 10 ventilated only | Randomised controlled trial (level 1b) | paCO2 up to 24 h (mean ± SD) | Surfactant v control: 5.0 ± 0.4 v 6.0 ± 0.4 at 24 h (p<0.05) | Mean age of 10.4 months for treated cases No blinding |
| paO2:FiO2 ratio up to 24 h (mean ± SD) | Surfactant v control: 30.8 ± 2.7 v 19.4 ± 1.6 kPa) | RSV+ cases: only 4 individuals 50 mg/kg curosurf used | |||
| Peak inspiratory pressures up to 24h (mean ± SD) | Surfactant v control: 28.5 ± 3.5 v 40.4 ± 2.4 cm H2O (p<0.01) | ||||
| Ventilation time (days) (mean ± SD) | Surfactant v control: 4.4 ± 0.4 v 8.9 ± 1.0 (p<0.05) | ||||
| ICU stay (days) (mean ± SD) | Surfactant v control: 10.1 ± 1.2 v 15.7 ± 1.5 (p<0.05) | ||||
| Vos et al (1996) | 2 infants. Both ventilated and given surfactant | Case series | Lung compliance and FiO2 | Increased lung compliance and decreased FiO2 | Case series |