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Neonatology pp 995-1006 | Cite as

Lung Diseases: Surfactant Replacement Therapy in Newborns

  • Henry L. Halliday
Reference work entry

Abstract

In the past three decades, introduction of prenatal steroid treatment, postnatal surfactant therapy, and assisted ventilation has contributed to better outcomes for neonates with respiratory distress syndrome (RDS). Improved survival is directly related to more effective prevention or treatment of the disease. RDS is caused by surfactant insufficiency leading to alveolar collapse and increased work of breathing with consequent hypoxia, respiratory failure, and mixed respiratory and metabolic acidosis. Following unsuccessful clinical trials in the 1960s with nebulized synthetic surfactants, comprised of phospholipids without surfactant proteins, a number of randomized controlled trials in the 1980s demonstrated benefits of surfactant instilled directly into the lungs of preterm infants. Currently, because of increased use of prenatal steroids and early CPAP, it is clear that early selective use of surfactant is superior to routine prophylactic treatment. However, there are still some occasions when surfactant should be administered in the delivery room including cases when intubation of very preterm infants is needed for stabilization.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Formerly Regional Neonatal UnitRoyal Maternity HospitalBelfastUK
  2. 2.Formerly Department of Child HealthQueen’s University BelfastBelfastUK

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