Surfactant Protein D for Pathological Evaluation of Infant Acute Respiratory Distress Syndrome Caused by Respiratory Syncytial Virus Infection

• 作者: Ayafumi Ozaki Daisuke Tamura Shun Inoue Takanori Yamagata Takatoshi Oishi
• 来源期刊: 儿科学期刊(英文)
• 学科: 医学
• 关键词: INFANTS Respiratory Syncytial Virus Acute Respiratory Distress Syndrome Surfactant Protein D KL-6
• 年，卷（期）: 2020,（4）
• 页码范围: 652-660
• 页数: 9页
• 分类号: R56

摘要

Pediatric respiratory syncytial viral infection (RS) usually shows </span><span style="font-family:Verdana;">relatively</span><span style="font-family:Verdana;"> good </span><span style="font-family:Verdana;">outcome</span><span style="font-family:Verdana;">;however, when it accompanies acute respiratory distress syndrome (ARDS), this becomes fatal. We experienced three pediatric patients with RS + ARDS, with all showing good </span><span style="font-family:Verdana;">outcome</span><span style="font-family:Verdana;"> with steroid pulse therapy. We wish to emphasize;1) steroid pulse therapy may become an option for this condition, and 2) plasma KL-6 and surfactant protein D levels may become a biomarker reflecting the disease progression/condition. Patients were, aged 1 month, 1 year 5 months, and 1 year 11 months. In all three, the respiratory condition deteriorated rapidly, requiring invasive ventilator management. Although the effectiveness of steroid treatment for ARDS is controversial, </span><span style="font-family:Verdana;">very</span><span style="font-family:Verdana;"> severe condition prompted us to employ steroid pulse therapy, after which, oxygenation rapidly improved without adverse events. Plasma KL-6 and surfactant protein D levels were measured during exacerbations of ARDS, steroid pulse therapy, and recovery. Surfactant protein D levels were closely associated with oxygenation, suggesting this substance level might be a biomarker of ARDS caused by the disruption of the alveolar epithelial lining and to understand oxygenation without time lag.