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Acute respiratory distress syndrome (ARDS) is a lung pathology induced by diverse injuries, including trauma, sepsis, liquid aspiration, inhaled gases, radiation pneumonitis and many others.
Despite the introduction of new treatments, the mortality from ARDS also in paediatric age remains high (about 40%).
The pathophysiological features of the acute lung injury in ARDS are similar to those observed in neonatal hyaline membrane disease, leading to speculation that ARDS might involve a surfactant deficiency.
Surfactant supplementation has been suggested but the treatment is unpredictable. Poor response may be due to inhibition of administered surfactant by plasma components filling the alveolar space, severity of lung injury, time of surfactant application and inadequate dose.
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