Conclusions
Surfactant treatment of RDS improves oxygcnation and ventilation whether given immediately after birth or after the onset of the disease. There is also a decrease in associated morbidity (air leak), and improved survival with no significant short term side effects. Information about long term follow-up is limited, but encouraging. The future should bring better surfactants (recombinant DNA human surfactant) and optimization of timing, multiplicity and size of dose, and technique of ventilation. This will allow for the survival of most of the premature infants beyond 25 weeks gestation with minimal morbidity. Surfactant treatment of RDS will go down as a true landmark in the history of neonatology.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Hochheim K. Uber einige Befunde in den Lungen von Neugeborenen und die Beziehung derselben zur Aspiration von Fruchtwasser.Centwlblatt fur Path 1903; 14: 537.
Avery ME, Mead J. Surface properties in relation to atelectasis and hyaline membrane disease.Am J Dis Child 1959: 97: 517–523.
Liggins GC, Howie RN. A controlleu trial of anteparrum glucocorticoid treatment for prevention of the respiratory distrees syndrome in premature infants.Pediatrics 1972; 50: 515.
Collaborative group on antenatal steroid therapy: Effect of antenatal dexamethasone administration on the presentation of respiratory distress syndrome.Am J Obstet Gynecol 1981; 141 : 276.
Baden M, Bauer CR, Colle E et al. A controlled trial of hydrocortisone therapy in infants with respiratory distress syndrome.Pediatrics 1972; 50: 526–534.
Robillard E, Alarie Y, Dagenais-Perusse P et al. Microaerosol administration of synthetic dipalmitoyl lecithin in the respiratory distress syndrome: A preliminary report.Can Med Assoc J 1964; 90 : 55–57.
Chu J, Clements JA, Cotton EK et al. Neonatal pulmonary ischemia: Clinical and physiologic studies.Pediatrics 1967; 40 : 709–782.
Enhorning G, Robertson B. Lung expansion in the premature rabbit fetus after trachcal deposition of surfactant.Pediatrics 1972; 50: 58–66.
Adams FH, Towers B, Osher AB et al. Effects of tracheal instillation of natural surfactant in premature lambs 1. Clinical and autopsy findings.Pediatr Res 1978; 12: 841–848.
Fujiwara T, Macta H, Chida S et al. Artificial surfactant therapy in hyaline-membrane disease.Lancet 1980; i: 55.
Hallman M, Merritt TA, Jarvenpaa L et al. Exogenous human surfactant for treatment of severe respiratory distress syndrome: A randomized prospective clinical trial.J Pediatr 1985; 106 : 963–969
Enhorning G, Shennan A, Possmayer I et al. Prevention of neonatal respiratory distress syndrome by tracheal instillation osurfactant: A randomized clinical trialPediatrics 1985; 76 : 145–153.
Gitlin Jt>, Soil RF, Parad RB et al. Randomized controlled trial of exogenous surfactant for the treatment of hyaline membrane disease.Pediatrics 1987; 79: 31–37.
Merritt TA, Hallman M, Bloom BT et al. Prophylactic treatment of very premature infants with human surfactant.N Engl J Med 1986; 315: 785–790.
Shapiro DL, Notter RH, Morin FC et al. Double–blind, randomized trial of a calf lung surfactant extract administered at birth to very premature infants for prevention of respiratory distress syndrome.Pediatrics 1985; 76: 593–599.
Raju TNK, Vidyasagar D, Bhat R et al. Double-blind controlled trial of singledose treatment with bovine surfactant in severe hyaline membrane disease.Lancet 1987; i: 651–655.
Kwong MS, Egan EA, Notter RH et al. Double-blind clinical trial of calf lung surfactant extract for the prevention of hyaline membrane disease in extremely premature infants.Pediatrics 1985; 76: 585–592.
Horbar JD, Soll RF, Sutherland JM et al. A multicenter randomized, placebo controlled trial of surfactant therapy for respiratory distress syndrome.N Engl J Med 1989; 320: 959–965.
Holliday HL, Me Clure G, Reid MM et al. Controlled trial of artificial surfactant to prevent respitatory distress syndrome.Lancet 1984; i: 476.
Wilkinson A, Jenkins PA, Jeffrey JA. Two controlled trials of dry artificial surfactant: Early effects and later outcome in babies with surfactant deficiency.Lancet 1985; ii: 287.
Konishi M, Fujiwara T, Naito T et al. Surfactant replacement therapy in neonatal RDS.Eur J Pediatr 1988; 147: 20–25.
Charon A, Taeusch W. Fitzgibbon C et al. Factors associated with surfactant, treatment response in infants with severe respiratory distress syndrome.Pediatrics 1989; 83: 348–354.
Ikegami M, Jobe A, Merry D. Apoprotein that inhibits surfactant in RDS.Biol Neonate 1986; 50: 121–129.
Mori N. Effect of vagal stimulation on synthesis of pulmonary surfactant: Maintenance of compliance by positive end-expiratory pressure.Masui 1981; 30: 788–795.
Fujiwara T, Konishi M, Chida S et al Factors affecting the response to a postnatal single dose of exogenous surfactant. In: Jobe A, Taeusch W (eds:Surfactant treatment of lung diseases. Reporr of the 96th Ross Conference on Pediatric Research. Columbus, OH, Ross Laboratories, 1988;
Walthcr FJ, Kuipers IM, Gidding CEM et al. A comparison of high frequency oscillation superimposed onto backup mechanical ventilation and conventional mechanical ventilation on the distribution of exogenous surfactant in premature lambs.Pediatr Res 1987; 22: 725–729.
Kawashima T, Chida S, Fujiwara T. Measurement of anti-surfactant proteolipid-5-KDa apoprotein antibodies in sera from HMD–patients treated with surfactant TA using an ESISA.J Perinat Med 1989; 17: 473.
Dunn MS, Shennan AT, Hoskms EM et al. Two–year follow-up of infants enrolled in a randomized trial of surfactant replacement therapy for prevention of neonatal respiratory distress syndrome.Pediatrics 1988; 82: 543–547.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Dhanireddy, R. Surfactant replacement therapy for neonatal respiratory distress syndrome. Indian J Pediatr 57, 743–749 (1990). https://doi.org/10.1007/BF02722267
Issue Date:
DOI: https://doi.org/10.1007/BF02722267