Late Start of Surfactant Therapy and Surfactant Drug Composition as Major Causes of Failure of Phase III Multi-Center Clinical Trials of Surfactant Therapy in Adults with ARDS

Abstract

To the Editor, We have read, with great interest, the Letter to the Editor by Grotberg et al.(2017), which puts forward reduced alveolar delivery as the major cause of the unexpectedly disappointing results of phase III, multi-center, controlled clinical trials of surfactant therapy in adults with acute respiratory distress syndrome (ARDS). We do hope that this will fuel a long-anticipated discussion on the causes of the failure of surfactant therapy for ARDS, despite abundant evidence from animal models with ARDS and some clinical trials that surfactant therapy is efficacious.

Keywords

• lung surfactants
• surfactant therapy
• ARDS
• clinical trials