Severe neonatal respiratory distress syndrome treated with the isolated phospholipid fraction of natural surfactant.
Ten newborn infants (795-1680 g) with severe respiratory distress syndrome (RDS) were treated with the isolated phospholipid fraction of bovine or porcine surfactant, which was administered via the airways (dose 200 mg/kg), at a median age of 10.5 h. Before receiving surfactant, all the infants were on artificial ventilation (FiO2 0.6-1.0). Within 2 h after surfactant replacement, the arterial-to-alveolar PO2 ratio increased from 0.1 to 0.35. There was a concomitant improvement in lung aeration on the chest roentgenograms and a significant reduction in the right-to-left shunt. Four patients died of cerebral hemorrhage; two of them also had a patent ductus arteriosus. One surviving infant developed bronchopulmonary dysplasia, and another succumbed 8 months later to the sudden infant death syndrome. No antibodies against surfactant were detected in the sera of the survivors. Since our results show a significant improvement in lung function after replacement therapy, the efficacy of this new surfactant preparation should be further tested in randomized clinical trials.
Noack
G
G
Department of Paediatrics, St. Göran's Hospital, Stockholm, Sweden.
Berggren
P
P
Curstedt
T
T
Grossmann
G
G
Herin
P
P
Mortensson
W
W
Nilsson
R
R
Robertson
B
B
D002850:Chromatography, Gel; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008168:Lung / Q000000981:diagnostic imaging; D008176:Lung Volume Measurements; D008297:Male; D010313:Partial Pressure; D010743:Phospholipids / Q000302:isolation & purification / Q000627:therapeutic use*; D011379:Prognosis; D011663:Pulmonary Surfactants / Q000032:analysis / Q000627:therapeutic use*; D011859:Radiography; D012127:Respiratory Distress Syndrome, Newborn / Q000150:complications / Q000401:mortality / Q000628:therapy*
D010743:Phospholipids; D011663:Pulmonary Surfactants