All issues > Volume 34(9); 1991

Original Article

J Korean Pediatr Soc. 1991;34(9):1211-1222. Published online September 30, 1991.

Surfactant replacement therapy in neonatal respiratory distress syndrome.

Chan Ok Park¹, Boung Yul Lim¹, Byeong Gie Yeo¹, Ji Ho Song¹, Eun Kyung Sohn¹, Chong Woo Bae¹, Sa Jun Chung¹, Chang Il Ahn¹

¹Department of Pediatrics, College of Medicine, Kyung Hee University, Seoul, Korea

Received: March 20, 1991;  Accepted: May 22, 1991.

Abstract

Respiratory distress syndrome (RDS) in tiny infants remains a major medical challenge as they are less tolerant of supportive care. In 1959, after identification of the pulmonary surfactant (S), S replacement therapy were used to treat RDS. This idea was first successfully tested on RDS infants by Fujiwara, et. al” in 1980. Now the trial and use of S for the treatment in RDS is also popular in other countries. We conducted a clinical trial of reconstitued bovine S(S-TA) comparing its efficacy in RDS. S-treated group of 6 neonates and control group of 8 neonates were involved this study. The results were as follows; 1) During the replacement of S through the endotracheal tube, hypoxia or hypercarbia were not noticed, and a dramatic elevation of PaO2 appeared. 2) After replacement of S, there were significantly improved oxygenation (increased arterial- alveolar O2 ratio) and chest roentgenographic findings, with decreased mean airway pressure and a fraction of inspired oxygen in the S-treated group, unlike the control group. 3) Infants in the S-treated group had a more beneficial effect in the shortening of the duration of oxygenation, mechanical ventilator care and timing of extubation of the endotracheal tube. 4) Infants in the S-treated group had less mortality and late complications than the infants in the control group. In conclusion, exogenous S replacement produced exellent results, which decreased pressure, oxygen concentration and improved chest X-ray findings during ventilator care in the acute stage. Also, there were decreased incidence of pulmonary and/or other complications during the late stage. So, S replacement will become a important advance in the care of preterm infants with severe RDS.

Keywords :Neonatal Respiratory Distress Syndrome;Surfactant Replacement