Premature infants have been known to die from pulmonary failure for many years. In the 1950s this cause of mortality in the neonatal period was treated supportively with temperature regulation, oxygen, and antibiotics. In the early 1960s it was determined that pulmonary failure was caused by lack of a surface active substance in the lung . This substance was named pulmonary surfactant, and the clinical disorder was named respiratory distress syndrome (RDS). The pathologic description of the disorder led to the name ‘‘hyaline membrane disease” . Therapies encompassing more specific measures, such as continuous positive airway pressure, ventilatory support, nutrition, and medications such as sodium bicarbonate, were devised to improve survival in infants with RDS [3,4]. Even with the utilization of these measures, RDS was still the major factor contributing to death in 11,900 infants per year in the years 1969 to 1973. The average contribution of RDS to the neonatal mortality rate—20%— made it the highest single factor associated with death in neonates .
KeywordsCholesterol Surfactant Ischemia Respiration Bicarbonate
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