Dahmer MK, Flori H, Sapru A, et al. - In this prospective cohort study, researchers intended to determine if there is an association between plasma surfactant protein D (SP-D) and lung injury in children with acute respiratory failure. This investigation was carried out in children 2 weeks to 17 years of age with acute respiratory failure who partook in the BALI multi-center study. The analysis was performed with plasma samples from 350 patients; 233 had pediatric ARDS (PARDS). SP-D levels differed across primary diagnoses. Multivariable analyses showed that elevated SP-D levels were correlated with death, duration of mechanical ventilation, PICU length of stay, and highest oxygenation index. In addition, SP-D levels correlated with age. In children with acute respiratory failure, elevated plasma SP-D levels are related to severe PARDS and poor outcomes.