Prevention of Neonatal Respiratory Distress Syndrome by Tracheal Instillation of Surfactant

Abstract

Abstract Surfactant deficiency was the suspected etiology of respiratory distress syndrome since 1959; after decades of bench and animal research to approach a safe and effective means of replacing surfactant, this was one of the first trials to show the immediate effects of surfactant on lung damage in infants. Infants born before 30 weeks at a single site who were intubated shortly after birth were randomly assigned to receive surfactant extracted from calf lungs (39 infants) or a sham injection of air (33 infants). Blood gas analysis showed improved oxygenation in the first 72 hours among infants who received surfactant. The a/A ratio was on average 0.15 higher in the surfactant group over the first 72 hours of life (p <0.05 at all time points). Fewer infants treated with surfactant had pulmonary interstitial emphysema on chest radiographs (3 versus 13; p <0.005), and fewer died in the neonatal period (1 versus 6; p <0.05).