PT  - JOURNAL ARTICLE
AU  - Reena M Bhatt
AU  - Howard W Clark
AU  - Massimo Girardis
AU  - Stefano Busani
TI  - Exogenous pulmonary surfactant in COVID-19 ARDS. The similarities to neonatal RDS suggest a new scenario for an ‘old’ strategy
AID  - 10.1136/bmjresp-2020-000867
DP  - 2021 Sep 01
TA  - BMJ Open Respiratory Research
PG  - e000867
VI  - 8
IP  - 1
4099  - http://bmjopenrespres.bmj.com/content/8/1/e000867.short
4100  - http://bmjopenrespres.bmj.com/content/8/1/e000867.full
SO  - BMJ Open Resp Res2021 Sep 01; 8
AB  - 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.Data are available on reasonable request.