Surfactant therapy

Abe, T. (1980). Artificial surfactant therapy in hyaline-membrane disease, Lancet. 1, 55-59. 

T Kobayashi, K Tashiro, X Cui, T Konzaki, Y Xu, C Kabata, K Yamamoto. Experimental models of acute respiratory distress syndrome clinical relevance and response to surfactant therapy. Biology Neonate 80 Suppl 1 26—28, 2001. 

F. Gerber, M.P. Krafft, T.F. Vandamme, M. Goldmann, P. Fontaine, Preventing crystallization of phospholipids in monolayers A new approach to lung surfactant therapy, Angew. Chem. Int. Ed. 44 (2005) 2749-2752. 

An apparent association between severe retinopathy of prematurity and dexamethasone therapy has been shown in a retrospective study (SEDA-20, 372 76). Infants treated with dexamethasone required longer periods of mechanical ventilation (44 versus 26 days), had a longer duration of supplemental oxygen (57 versus 29 days), had a higher incidence of patent ductus arteriosus (28/38 versus 18/52), and required surfactant therapy more often for respiratory distress syndrome (17/38 versus 11/52). Prospective, randomized, controlled studies are needed to correct for differences in severity of cardiorespiratory disease. Until such studies are available, careful consideration must be given to indications, dosage, time of initiation, and duration of treatment with dexamethasone in infants of extremely low birthweight. 

Surfactant Therapy for Lung Disease, edited by B. Robertson and H. W. Taeusch... 

Surfactant therapy is used to prevent an infant s lungs from collapsing and sticking together. Which of these is the most reasonable rationale for this... 

Verder H, Robertson B, Greisen G, et al. Surfactant therapy and nasal continuous positive airway pressure for newborns with respiratory distress syndrome. N Engl J Med 1994 331 1051-1055. 

Artificial pulmonary surfactant therapy has dramatically reduced premature infant death caused by RDS and appears to have reduced overall mortality for all babies bom weighing less than 700 g (about 1.5 pounds). Advances such as this have come about as a result of research on the makeup of body tissues and secretions in both healthy and diseased individuals. Often, such basic research provides the information needed to develop effective therapies. 

In order to determine the infants lung maturity and the necessity of surfactant therapy it is of great importance to substantiate the functionality of the alveolar surfactant, derived via invasive techniques [13], Several techniques and models have been largely used to investigate inteifacial physicochemical properties in vitro and to assess clinical efficiency of ES in vivo the Langmuir monolayer technique in combination with Wilhelmy plate method for surface tension measurements and black foam film method for determination of the ability of ES for stable film formation [14]. The pendant drop method combined with the Axisym-metric Drop Shape Analysis (ADSA) has been also used for similar purposes [4,15-18]. 

The results showed that the infants with untreated NRDS had high equilibrium, maximal and minimal y values of the tracheal aspirate. In contrast, the clinical samples from infants after surfactant therapy with Curosurf showed low surface tension values, suggesting that the application of the exogenous surfactant improved the composition and the properties of the pulmonary surfactant in the infants. These results are in agreement with previous reports regarding the efficiency of surfactant application [14]. 

A common problem for premature babies is their lack of pulmonary surfactant. The pulmonary surfactant is formed late in pregnancy, and a premature baby born without the surfactant can experience respiratory distress syndrome, whereby the alveoli can collapse, a potentially fatal condition. Treatment of newborn premature babies with a lung surfactant therapy was a major advance in neonatal medicine. 

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