Infasurf®(Calfactant) Aerosol for Infants With Bronchiolitis-AERO-04

This pilot clinical trial will compare "usual care" to aerosolized Infasurf. The study
objective is to determine

1. Do bronchiolitis patients tolerate aerosolized Infasurf?

2. Does aerosolized Infasurf induce an improvement in respiration?

3. If it does how large a dose is required to observe a positive effect?

4. Is the positive effect transient, if so what is the range of duration of the effect?

5. Does retreatment also result and a positive response?

6. Does aerosolized Infasurf result in more rapid sustained improvement? is superior to.

Inclusion Criteria:

1. Infant ≤ 4 months of age admitted to the PICU with the clinical diagnosis of
bronchiolitis

2. Severe illness as reflected by a bronchiolitis score ≥ 4 and requiring high flow nasal
cannula or continuous positive airway pressure for respiratory support

3. Within 4 hours of PICU admission.

Exclusion Criteria:

1. Need for non-invasive BiPAP or invasive ventilation

2. Significant Co-morbidities

1. Chronic lung disease (evidenced by supplemental oxygen, home ventilation, or
chronic diuretic therapy for CLD)

2. Unrepaired congenital heart disease

3. Immune compromise

4. Neuromuscular weakness

3. Tracheostomy

4. Influenza as the etiologic agent of bronchiolitis

5. Inability to stabilize the infant to a bronchiolitis score < 8