Dahmer MK, Flori H, Sapru A, et al. - Researchers investigated whether plasma surfactant protein D (SP-D) is related to lung injury or outcome in children experiencing acute respiratory failure, via this prospective cohort study. The participants were selected from the BALI multi-center study, and included children 2 weeks to 17 years of age encountering acute respiratory failure. Enzyme-linked immunosorbent assay was used to measure SP-D level. From 350 patients, plasma samples were analyzed; 233 were found to have pediatric acute respiratory distress syndrome (PARDS). A link of elevated SP-D levels with death, duration of mechanical ventilation, PICU length of stay, and highest oxygenation index, was indicated in multivariable analyses. Also, a correlation of SP-D levels with age was identified. Overall, in this patient population, a link of elevated plasma SP-D levels with severe PARDS as well as with poor outcomes was evident.