Exogenous Pulmonary Surfactant in COVID-19 ARDS. The Similarities to Neonatal RDS Suggest a New Scenario for an 'old' Strategy

Overview

Journal BMJ Open Respir Res

Date 2021 Sep 15

PMID 34521648

Citations 7

Authors

Reena M Bhatt

Howard W Clark

Massimo Girardis

Stefano Busani

Affiliations

Soon will be listed here.

Abstract

Acute respiratory distress syndrome (ARDS) related to SARS-CoV-2 infection has some unusual characteristics that differentiate it from the pathophysiology described in the more 'typical' ARDS. Among multiple hypotheses, a close similarity has been suggested between COVID-19 ARDS and neonatal respiratory distress syndrome (RDS). With this opinion paper, we investigated the pathophysiological similarities between infant respiratory diseases (RDS and direct neonatal ARDS (NARDS)) and COVID-19 in adults. We also analysed, for the first time, similarities in the response to exogenous surfactant administration in terms of improved static compliance in RDS and direct NARDS, and adult COVID-19 ARDS. In conclusion, we believe that if the pathological processes are similar both from the pathophysiological point of view and from the response in respiratory mechanics to a recruitment treatment such as surfactant, perhaps the latter could be considered a plausible option and lead to recruitment in clinical trials currently ongoing on patients with COVID-19.

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