Factors affecting surfactant responsiveness.
There is a wide variability in the therapeutic responsiveness to exogenous surfactant, a drug that has become generally available for the treatment of lung immaturity and respiratory distress syndrome. Recent studies have demonstrated evidence that therapies decreasing lung edema improve the effectiveness of surfactant substitution. In addition, exogenous surfactant may acutely decrease pulmonary perfusion since the airway pressures are effectively transmitted to airspaces, compressing alveolar capillaries, especially in hypovolemia. Therapies aimed at decreasing lung edema, improving cardiac output, and stepwise weaning from oxygen and ventilatory pressures are cornerstones in the successful management of patients undergoing surfactant therapy.
Hallman
M
M
Division of Neonatal-Perinatal Medicine, University of California, Irvine 92717.
Merritt
T A
TA
Kari
A
A
Bry
K
K
D004374:Ductus Arteriosus, Patent / Q000150:complications; D005440:Fluid Therapy; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D008168:Lung / Q000196:embryology; D011654:Pulmonary Edema / Q000150:complications; D011663:Pulmonary Surfactants / Q000627:therapeutic use*; D012121:Respiration, Artificial; D012127:Respiratory Distress Syndrome, Newborn / Q000150:complications / Q000628:therapy*
D011663:Pulmonary Surfactants