Lucinactant for Treatment of Acute Hypoxemic Respiratory Failure in Children up to Two Years Old

Inclusion Criteria: * ≥ 38 weeks (corrected age) to 2 years (24 months) * Intubated and mechanically ventilated (MV) for ≥ 6 hours and anticipated need for MV for ≥ 24 hours * Persistent hypoxia * Written informed consent Exclusion Criteria: * Mechanical Ventilation for \> 48 hours * Oxygenation index ≥ 25, if arterial line was avialable * Pre-existing clinically significant or palliated/uncorrected cardiac disease adversely affecting cardiopulmonary function and gas exchange * Neuromuscular disease or hypotonia * Upper airway disease * Baseline requirment for supplemental oxygen * Untreated pneumothorax * Off-label use of commercially available surfactant outside neonatal period * History of prematurity and passive immunoprophylaxis with humanized monoclonal antibody * Head injury with Glasgow Coma Scale \< 8 * Brain death or impending brain death * Do not resuscitate orders * Cardiopulmonary resuscitation within 6 hours of meeting entry criteria * Experimental therapy in which the intervention potentially affects respiratory outcomes * Any transplant recipient * Meconium aspiration syndrome * Bordetella pertussis infection confirmed via laboratory tests and/or highly suspected pertussis infection