TITLE:
Surfactant Protein D for Pathological Evaluation of Infant Acute Respiratory Distress Syndrome Caused by Respiratory Syncytial Virus Infection
AUTHORS:
Daisuke Tamura, Shun Inoue, Takatoshi Oishi, Ayafumi Ozaki, Takanori Yamagata
KEYWORDS:
Infants, Respiratory Syncytial Virus, Acute Respiratory Distress Syndrome, Surfactant Protein D, KL-6
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.10 No.4,
December
4,
2020
ABSTRACT: Pediatric
respiratory syncytial viral infection (RS) usually shows relatively good outcome;
however, when it accompanies acute respiratory distress syndrome (ARDS), this
becomes fatal. We experienced three pediatric patients with RS + ARDS, with all
showing good outcome 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, very 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.