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the use of surfactant for babies with severe bronchiolitis on PICU


the use of surfactant for babies with severe bronchiolitis on PICU
Funding NIHR EME
Portfolio Paediatric, foetal and maternal health
Interventions Medicine
Randomised Yes
Status Recruiting
Start Date 17-Dec-2018

Bronchiolitis is a winter viral chest infection that causes breathing difficulties in babies. It is the single most common reason for hospital admission of babies in England, with over 25,000 per year. There is no vaccine or specific treatment. Breathing fails in very severe cases, and these babies need intensive care to go on a breathing machine called a mechanical ventilator. Surfactant is in the liquid produced in healthy lungs that allows the lungs to inflate more easily. Surfactant therapy is safe and established for use in premature babies for over 30 years. We have already shown that babies with bronchiolitis have less surfactant than they need for their lungs to work normally. Three small studies that gave half the dose of surfactant that is now recommended improved babies breathing for several hours and most babies recovered and left PICU quicker. We want to find out if surfactant reduces the time critically ill babies with bronchiolitis spend on a mechanical ventilator. Our study will use the higher doses now recommended and involve more babies. We will give surfactant to 141 babies over two days and a dummy procedure to 141 babies. The PICU staff and research team will not know who gets what until the end of the study. We will do tests to measure how much surfactant the babies are making; how much of the surfactant that we give is staying in the lungs; which virus and bacteria are infecting the airways and how much inflammation is in the airways. Babies that have severe bronchiolitis often have more episodes of chestiness and wheeze in the months after their illness than those that did not have bronchiolitis. It is possible that the surfactant given in this study may help reduce these symptoms. We will ask parents to complete a questionnaire after their baby goes home to tell us about any respiratory symptoms they notice in their baby

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