Meng SS, et al. - In this meta-analysis of 11 randomized controlled trials including 3,038 patients, researchers assessed the impact of surfactant administration on outcomes of adult patients with acute respiratory distress syndrome (ARDS). Trials comparing surfactant administration with general therapy in adult patients with ARDS were identified from PubMed, EMBASE, Medline, Cochrane database, Elsevier, Web of Science and clinicaltrials.gov until December 2017. The main outcome of interest was mortality (7–10-day, 28–30-day and 90–180-day). Oxygenation (PaO2/FiO2 ratio) was also assessed. For evaluating quality levels, they used Grading of Recommendations Assessment, Development, and Evaluation methodology(GRADE). Findings revealed no improved mortality or improved oxygenation in association with surfactant administration in adult ARDS patients. There was a lack of a firm evidence demonstrating a beneficial impact, as indicated by trial sequential analysis (TSA) and GRADE.