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Severe Neonatal Respiratory Distress Syndrome Treated with the Isolated Phospholipid Fraction of Natural Surfactant
Author(s) -
NOACK G.,
BERGGREN P.,
CURSTEDT T.,
GROSSMANN G.,
HERIN P.,
MORTENSSON W.,
NILSSON R.,
ROBERTSON B.
Publication year - 1987
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1987.tb10552.x
Subject(s) - medicine , respiratory distress , bronchopulmonary dysplasia , pulmonary surfactant , neonatal respiratory distress syndrome , fraction of inspired oxygen , ductus arteriosus , mechanical ventilation , surfactant therapy , pulmonary hemorrhage , lung , anesthesia , pulmonary shunt , gestational age , pregnancy , physics , biology , genetics , thermodynamics
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 (FiO 2 0.6–1.0). Within 2 h after surfactant replacement, the arterial‐to‐alveolar P O2 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.