Exogenous human surfactant for treatment of severe respiratory distress syndrome: A randomized prospective clinical trial*

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We performed a randomized, prospective clinical trial comparing intratracheal administration of human surfactant with conventional treatment with intermittent mandatory mechanical ventilation alone for treatment of severe respiratory distress syndrome in preterm infants of <30 weeks gestation. Twenty-two infants (mean gestational age 27.0 weeks, mean birth weight 987 gm) were given surfactant, and 23 infants (mean gestational age 27.2 week, mean birth weight 1055 gm) received intermittent mandatory ventilation. Infants given surfactant required less FiO2 during the first week, had lower mean airway pressure during the first 48 hours, and had improved ventilatory index and a/A Po2 ratio. Death or the occurrence of bronchopulmonary dysplasia was significantly less among infants given surfactant (P=0.019). Pneumothorax, pulmonary interstitial emphysema, and need for Fio2≥0.3 for >30 days was significantly less in the surfactant group. This trial confirms the efficacy of treatment with human surfactant in preterm infants with severe respiratory distress syndrome.

References (20)

  • AveryME et al.

    Surface properties in relation to atelectasis and hyaline membrane disease

    Am J Dis Child

    (1959)
  • HallmanM et al.

    Isolation of human surfactant from amniotic fluid and a pilot study of its efficacy in respiratory distress syndrome

    Pediatrics

    (1981)
  • StrayerDK et al.

    Immune complex formation in respiratory distress syndrome

    Pediatr Res

    (1984)
  • FujiwaraT et al.

    Artificial surfactant therapy in hyaline membrane diseases

    Lancet

    (1980)
  • MorleyCJ et al.

    Dry artificial lung surfactant and its effect on very premature babies

    Lancet

    (1981)
  • SmythJA et al.

    Hyaline membrane disease treated with bovine surfactant

    Pediatrics

    (1981)
  • HallidayHL et al.

    Controlled trial of artificial surfactant to prevent respiratory distress syndrome

    Lancet

    (1977)
  • HallmanM et al.

    Absence of phosphatidylglycerol (PG) in respiratory distress syndrome in the newborn

    Pediatr Res

    (1977)
  • ManninoFL et al.

    The management of respiratory distress syndrome

  • PapileL et al.

    Incidence and evolution of subependymal and intraventricular hemorrhage: A study of infants with birth weights less than 1500 gm

    Pediatrics

    (1983)
There are more references available in the full text version of this article.

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*

Supported by Grants HD-16292 (T.A.M.) and HD-10622 (L.G.) from the National Institute of Child Health and Human Development, by a Clinical Research Grant from the March of Dimes/Birth Defects Foundation (T.A.M.), by the Finnish Academy, and by the Sigrid Juselius Foundation (M.H.). Presented in part at a meeting of the Society for Pediatric Research, San Francisco, May 1984.

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