[Acute respiratory failure (ARDS) in a young child after drowning accident: therapy with exogenous surfactant and high frequency oscillatory ventilation].

The adult respiratory distress syndrome (ARDS) in children has a very poor prognosis with a mortality risk of between 55 and 85%, in spite of improvements due to the introduction of positive endexpiratory pressure ventilation. We describe the clinical course of a not yet 3 year-old boy with severe ARDS following near-drowing. Treatment with exogenous surfactant and high frequency oscillatory ventilation, a well-established procedure in neonatology, was responsible for the favorable outcome. The high cost of surfactant therapy, however, is the main limiting factor for this kind of treatment in children beyond the neonatal period, but it may be the last therapeutic resort in the management of severe ARDS.