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Surfactant and Pediatric Acute Lung InjuryReply
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| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
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In Reply: We agree with Drs Hunt, Schwartz, and Fackler that the statement in the abstract of our article that calfactant " . . . significantly decreased mortality in infants, children, and adolescents with ALI . . . "1 should not be construed to imply that mortality was significantly decreased in each age group. Study entry was not stratified by age, and the subgroup analysis of infants was performed post hoc in an attempt to understand if the observed survival difference was limited to this age group.
The influence of age on response to surfactant was confounded by differences between infants and the older children in the predominant mechanism of lung injury and other risk factors. Infants more frequently had "direct" rather than "indirect" lung injury (77% vs 60% of older children) and we observed that patients with "direct" lung injury respond more positively to surfactant, which is consistent with the findings reported by Spragg et al.2 Additionally, . . . [Full Text of this Article]
Douglas F. Willson, MD
dfw4m@virginia.edu Department of Pediatrics University of Virginia Charlottesville
Edward A. Egan, MD
ONY Inc Amherst, NY
Neal J. Thomas, MD
Department of Pediatrics Pennsylvania State University Hershey
Joseph V. DiCarlo, MD
Department of Pediatrics Stanford University School of Medicine Palo Alto, Calif
Steven Pon, MD
Department of Pediatrics Weill Medical College of Cornell University New York, NY
Larry Jefferson, MD
Department of Pediatrics Baylor College of Medicine Houston, Tex
Brian Jacobs, MD
Department of Pediatrics University of Cincinnati College of Medicine Cincinnati, Ohio
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