title: Secondary surfactant deficiency in neonates.
abstract: Surfactant treatment has become the standard of care in premature infants with respiratory distress syndrome (RDS). Pulmonary hemorrhage, pulmonary edema, pneumonia, and atelectasis have been shown to liberate inflammatory mediators and plasma proteins, which damage type II pneumocytes and inactivate surfactant. These disease processes may, therefore, lead to a secondary surfactant inactivation or deficiency, which can be an unrecognized cause of respiratory decompensation after initial recovery from RDS in this vulnerable population. This is a descriptive report of three cases, which had acute respiratory decompensation between 1 and 3 weeks of age. All three infants demonstrated a response to secondary doses of surfactant. We submit that the diagnosis and treatment of secondary surfactant deficiency in the critically ill premature neonate warrants further study.
authors.affiliation: College of Nursing, Medical University of South Carolina, SC 29445, USA.
authors.forename: Robin
authors.initials: R
authors.lastname: Bissinger
authors.forename: Cheryl
authors.initials: C
authors.lastname: Carlson
authors.forename: Tom
authors.initials: T
authors.lastname: Hulsey
authors.forename: Dorothea
authors.initials: D
authors.lastname: Eicher
mesh_terms: D000328:Adult; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D011247:Pregnancy; D011663:Pulmonary Surfactants / Q000378:metabolism / Q000627:therapeutic use*; D012127:Respiratory Distress Syndrome, Newborn / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D012129:Respiratory Function Tests; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D011663:Pulmonary Surfactants