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, Volume 38, Issue 4, pp 591–611 | Cite as

Exogenous Surfactant Treatments for Neonatal Respiratory Distress Syndrome and their Potential Role in the Adult Respiratory Distress Syndrome

  • T. Allen Merritt
  • Mikko Hallman
  • Roger Spragg
  • Gregory P. Heldt
  • Nicholas Gilliard
Review Article

Summary

Exogenous surfactant therapy has been recognised as an approach to alleviating the surfactant-deficient state for 3 decades. Natural and lipid-extracted surfactants derived from amniotic fluid, lung lavage, or lung homogenates are being used in worldwide clinical trials in premature infants. These studies are demonstrating a generally favourable influence on lung function by improving oxygénation and reducing the risk for pneumothorax and pulmonary interstitial emphysema. In some studies, reduction in death and the occurrence of bronchopulmonary dysplasia have been found. Numerous questions are unresolved and pharmacokinetic data are limited in preterm infants. Artificial surfactants are similarly under evaluation but current data demonstrate less overall effect.

Adult respiratory distress syndrome has also been treated with exogenous surfactants. Although complex in terms of multiple initiating factors and in terms of high permeability of surfactant inhibitors, further studies are under way to determine the ideal methods of administration to enhance distribution and to monitor surfactant function in vivo.

Keywords

Respiratory Distress Syndrome DPPC Hyaline Membrane Disease Surfactant Therapy Exogenous Surfactant 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Adams FH, Towers B, Oshner AB, Ikegami M, Fujiwara T, et al. Effects of trachea! instillation of natural surfactant in premature lambs. I. Clinical and autopsy findings. Pediatric Research 12: 841–848, 1978PubMedGoogle Scholar
  2. Avery ME, Mead J. Surface properties in relation to atelectasis and hyaline membrane disease. American Journal of Diseases of Children 96: 517–523, 1959Google Scholar
  3. Baldwin SR, Simon RH, Grum CM, Ketai LH, Boxer LA, et al. Oxidative activity in expired breath of patients with adult respiratory distress syndrome. Lancet 1: 11–14, 1986PubMedGoogle Scholar
  4. Berggren P, Curstedt T, Grossman G, Robertson B. Bynnsam effekt av surfaktantbehandling vid IRDS. Läkartidningen 81: 4180, 1984PubMedGoogle Scholar
  5. Bermel MS, McBride JT, Notter RH. Lavaged excised rat lungs as a model of surfactant deficiency. Lung 162: 99–113, 1984PubMedGoogle Scholar
  6. Bloom BT. Human surfactant and calf lung surfactant extract: moderation of respiratory distress in preterm infants by a single prophylactic dose in a randomized and controlled clinical trial. In Lachmann B (Ed.). Surfactant replacement therapy in neonatal and adult respiratory distress syndrome, pp. 150–157, Springer/Verlag, New York, 1988Google Scholar
  7. Bredenberg CE, Nieman GF, Paskanik AM, Hart KE. Microvascular membrane permeability in high surface tension pulmonary edema. Journal of Applied Physiology 60: 253–259, 1986PubMedGoogle Scholar
  8. Christner P, Fein A, Goldberg S, Lippman M, Abrams W, et al. Collagenase in the lower respiratory tract of patients with adult respiratory distress syndrome. American Review of Respiratory Disease 131: 690–695, 1985PubMedGoogle Scholar
  9. Chu J, Clements JA, Cotton EK, Klaus MH, Sweet AY, et al. Neonatal pulmonary ischemia: clinical and physiological studdies. Pediatrics 40: 709–782, 1967PubMedGoogle Scholar
  10. Clements JA. Dependence of pressure-volume characteristics of lungs on intrinsic surface active material. American Journal of Physiology 187: 592–593, 1956Google Scholar
  11. Clyman RI, Jobe A, Heymann MA, Ikegami M, Roman C, et al. Increased shunt through the patent ductus arteriosus after surfactant replacement therapy. Journal of Pediatrics 100: 101–107, 1982PubMedGoogle Scholar
  12. Cochrane CG, Spragg RG, Revak S. Studies of the pathogenesis of the adult respiratory distress syndrome: evidence of oxidant activity in bronchoalveolar lavage fluid. Journal of Clinical Investigation 71: 754–761, 1983PubMedGoogle Scholar
  13. Collaborative European Multicentre Study Group. Surfactant replacement therapy for severe neonatal respiratory distress syndrome: an international randomized, clinical trial. Pediatrics 82: 683–691, 1988Google Scholar
  14. Davis J, Veness-Meehan K, Notter R, Bhutani VK, Kendig JW, et al. Changes in pulmonary mechanics after the administration of surfactant to infants with respiratory distress syndrome. New England Journal of Medicine 319: 476–479, 1988PubMedGoogle Scholar
  15. Dunn MS, Shennan AT, Hoskins EM, Lennox K, Enhorning G. Two-year follow-up of infants enrolled in a randomized trial of surfactant therapy for prevention of neonatal respiratory distress syndrome. Pediatrics 82: 543–548, 1988PubMedGoogle Scholar
  16. Durand DJ, Clyman RI, Heymann MA, Clements JA, Mauray F, et al. Effects of a protein-free synthetic on the survival and pulmonary function of preterm lambs. Journal of Pediatrics 107: 775–780, 1985PubMedGoogle Scholar
  17. de Lemos RA, Kuehl T. Animal models for evaluation of drugs for use in the mature and immature newborn. Pediatrics 79: 275–280, 1987Google Scholar
  18. Edwards DK, von Hilton S, Merritt TA, Hallman M, Mannino F, et al. Respiratory distress syndrome treated with human surfactant: radiographie findings. Radiology 157: 329–334, 1985PubMedGoogle Scholar
  19. Egan EA, Notter RH, Kwong MS, Shapiro DL. Natural and artificial lung surfactant replacement therapy in premature lambs. Journal of Applied Physiology 55: 875–883, 1983PubMedGoogle Scholar
  20. Enhorning G. Pulsating bubble technique for evaluating pulmonary surfactant. Journal of Applied Physiology 43: 198–203, 1977PubMedGoogle Scholar
  21. Enhorning G, Robertson B. Lung expansion in the premature rabbit fetus after tracheal deposition of surfactant. Pediatrics 50: 58–66, 1972PubMedGoogle Scholar
  22. Enhorning G, Shennan A, Possmayer F, Dunn M, Chen CP, et al. Prevention of neonatal respiratory distress syndrome by tracheal instillation of surfactant: a randomized clinical trial. Pediatrics 76: 145–153, 1985PubMedGoogle Scholar
  23. Fuchimukai T, Fujiwara T, Takahashi A, Enhorning G. Artificial pulmonary surfactant inhibited by proteins. Journal of Applied Physiology 62: 429–437, 1987PubMedGoogle Scholar
  24. Fujiwara T, Chida S, Watabe Y, Maeta H, Morita T, et al. Artificial surfactant therapy in hyaline membrane disease. Lancet 1: 55–59, 1980PubMedGoogle Scholar
  25. Fujiwara T, Konishi M, Chida S. Exogenous surfactant therapy in infants with RDS: comparison of early vs late treatment. Pediatric Research 81: 353A, 1984Google Scholar
  26. Fujiwara T. Surfactant replacement in neonatal RDS. In Robertson B et al. (Eds) Pulmonary surfactant, p. 479, Elsevier, Amsterdam, 1984Google Scholar
  27. Gitlin JD, Soil RF, Parad RB. Randomized controlled trial of exogenous surfactant for the treatment of hyaline membrane disease. Pediatrics 79: 31, 1987PubMedGoogle Scholar
  28. Gluck L, Kulovich M, Borer RC, Brenner PH, Anderson GG, et al. Diagnosis of the respiratory distress syndrome by amniocentesis. American Journal of Obstetrics and Gynecology 109: 440–445, 1971PubMedGoogle Scholar
  29. Goldenthal EJ. Food and Drug Administration Papers, pp. 13–18, May 1968Google Scholar
  30. Halliday HL, McClure BG, Reid M. The first 50 babies with severe hyaline membrane disease treated with Curosurf in Belfast. Presented at the Fifth International Berlin Symposium on Infant Mortality, Berlin, September 5, 1988Google Scholar
  31. Halliday HL, McClure G, Reid M. Growth and development two years after artificial surfactant replacement at birth. Early Human Development 13: 323–327, 1986PubMedGoogle Scholar
  32. Halliday HL, McClure G, Reid M, Lappin TRS, Meban C, et al. Controlled trial of artificial surfactant to prevent respiratory distress syndrome. Lancet 1: 476–478, 1984PubMedGoogle Scholar
  33. Hallman M, Gluck L. Phosphatidylglycerol in lung surfactant. III. Possible modifier of surfactant function. Journal of Lipid Research 17: 257–262, 1976PubMedGoogle Scholar
  34. Hallman M, Merritt TA, Pohjavuori M, Gluck L. Effect of surfactant substitution on lung effluent phospholipids in respiratory distress syndrome: evaluation of surfactant phospho-lipid turnover, pool size, and the relationships to severity of respiratory failure. Pediatric Research 20: 1228–1235, 1986aPubMedGoogle Scholar
  35. Hallman M, Merritt TA, Schneider H. Isolation of Human Surfactant from amniotic fluid and a pilot study of its efficacy in respiratory distress syndrome. Pediatrics 71: 473–482, 1983PubMedGoogle Scholar
  36. Hallman M, Slivka S, Wozniak P, Sills J. Perinatal development of myo-inositol uptake into lung cells: surfactant phosphatidylglycerol and phosphatidylinositol synthesis in the rabbit. Pediatric Research 20: 179–185, 1986bPubMedGoogle Scholar
  37. Hallman M, Spragg RG, Harrell JH, Moser KM, Gluck L. Evidence of lung surfactant abnormality in respiratory failure: study of bronchoalveolar lavage phospholipids, surface activity, phospholipase activity, and plasma myoinositol. Journal of Clinical Investigation 70: 673–683, 1982PubMedGoogle Scholar
  38. Hawgood S, Benson BJ, Schilling J, Damm D, Clements JA, et al. Nucleotide and aminp acid sequences of pulmonary surfactant protein SP 18 and evidence for cooperation between SP 18 and SP 28–36 in surfactant lipid adsorption. Proceedings of the National Academy of Sciences (USA) 84: 66–70, 1987Google Scholar
  39. Heldt GP, Pesonen E, Merritt TA, Elias W, Sahn DJ. Closure of the ductus arteriosus and mechanics of breathing in preterm infants following surfactant replacement therapy. Pediatric Research 25: 305–315, 1989PubMedGoogle Scholar
  40. Holm BA, Notter RH. Effects of hemoglobin and cell membrane lipids on pulmonary surfactant activity. Journal of Applied Physiology 63: 1434–1442, 1987PubMedGoogle Scholar
  41. Holm BA, Notter RH, Finkelstein JN. Surface property changes from interactions of albumin with natural lung surfactant and extracted lung lipids. Chemistry and Physics of Lipids 38: 287–298, 1985PubMedGoogle Scholar
  42. Horbar JD, Linderkamp O, Schachinger H, Versmold H, Duc G, et al. European trial of single dose Surfactant TA (STA) for treatment of respiratory distress syndrome (RDS). Pediatric Research 23: 510, 1988Google Scholar
  43. Horbar JD, Soil RF, Sutherland JM, Kotagal U, Philip AGS, et al. A multicenter randomized, placebo-controlled trial of surfactant therapy for respiratory distress syndrome. New England Journal of Medicine 320: 959–965, 1989PubMedGoogle Scholar
  44. Hull WM, Whitsett JA. Immunologie analysis of infants receiving Surfactant TA. Abstract. Pediatric Research 23: 411, 1988Google Scholar
  45. Ikegami M, Adams FH, Towers B, Osher AB. The quantity of natural surfactant necessary to prevent the respiratory distress syndrome in premature lambs. Pediatric Research 14: 1082–1085, 1982Google Scholar
  46. Ikegami M, Jobe A, Jacobs H, Lam R. A protein from airways of premature lambs that inhibits surfactant function. Journal of Applied Physiology 57: 1134–1142, 1984PubMedGoogle Scholar
  47. Jianwu L, Chao C, Hanzheng J. Treatment of hyaline membrane disease with human amniotie fluid surfactant. Journal of the Chinese Academy of Medicine 77: 231, 1988Google Scholar
  48. Jobe A, Ikegami M. Surfactant for the treatment of respiratory distress syndrome. American Review of Respiratory Disease 135: 1256–1275, 1987Google Scholar
  49. Kellog EW, Fridovich I. Liposome oxidation and erythrocyte lysis by enzymatically generated Superoxide and hydrogen peroxide. Journal of Biological Chemistry 752: 6721–6728, 1977Google Scholar
  50. Kendig JW, Notter RH, Cox C, Aschner JF, Benn S, et al. Surfactant replacement therapy at birth: final analysis of a clinical trial and comparisons with similar trials. Pediatrics 82: 756–762, 1988PubMedGoogle Scholar
  51. Kendig JW, Notter RH, Cox C, et al. A clinical trial of single dose surfactant replacement therapy at birth: final analysis. Pediatric Research 23: 413, 1988Google Scholar
  52. King RJ, Klaus DJ, Gikas EG, Clements JA. Isolation of apoprotein from canine surface active material. American Journal of Physiology 224: 786–795, 1973Google Scholar
  53. Klaus MH, Clements JA, Havel RJ. Composition of surface-active material isolated from beef lung. Proceedings of the National Academy of Sciences (USA) 47: 1858–1859, 1961Google Scholar
  54. Kobayashi T, Kataoka H, Murakami S. A case of idiopathic respiratory distress syndrome treated by a newly developed surfactant (surfactant CK). J. Japan Med Soc Biol Interface 12: 1, 1981Google Scholar
  55. Konishi M, Surfactant Study Group. Method of surfactant replacement therapy in RDS: multicenter randomized study for determination of the replacement dose. Shonika Rinsho 39: 161–174, 1986Google Scholar
  56. Kwong MS, Egan EA, Notter RH, Shapiro DL. Double-blind clinical trial of calf lung surfactant extract for the prevention of hyaline membrane in extremely premature infants. Pediatrics 76: 585, 1985PubMedGoogle Scholar
  57. Kwong MS, Egan EA. Routine use of Intrasurf (Calf Lung Surfactant Extract) at birth for prematures ⩽ 32 weeks gestation. Pediatric Research 23: 415A, 1988Google Scholar
  58. Lang MJ, Rhodes P, Reddy S, Kurth G, Merritt TA, et al. Limitation of the effective use of Human Surfactant (HS) in established RDS. Pediatric Research 23: 513A, 1988Google Scholar
  59. Lee CT, Fein AM, Lippman ML, Holtzrhan H, Kimbel P, et al. Elastolytic activity in pulmonary lavage fluid from patients with adult respiratory distress syndrome. New England Journal of Medicine 304: 192–196, 1981PubMedGoogle Scholar
  60. Long WA, Sanders RL. New treatment methods in neonatal respiratory distress syndrome: replacement of surface active material. In Guthrie RD (Ed.) Neonatal intensive care, pp. 21–56, Churchill Livingston, New York, 1988Google Scholar
  61. Mason RJ, Nellenbogen J, Clements JA. Isolation of desaturated phosphatidylcholine with osmium tetroxide. Journal of Lipid Research 17: 281–284, 1976PubMedGoogle Scholar
  62. Matalon S, Baker RR, Freeman BA, et al. Catalase and superoxide dismutase-type activities in lung surfactant. Presented at the Third International Symposium, ‘Basic Research on Lung Surfactant’, Marburg, Germany, September 12–14, 1988Google Scholar
  63. McCord FB, Curstedt T, Halliday HL, McClure G, Reid M, et al. Surfactant treatment and incidence of intraventricular haemorrhage in severe respiratory distress syndrome. Archives of Disease in Childhood 63: 10–16, 1988PubMedGoogle Scholar
  64. McGuire WW, Spragg RG, Cohen AB, Cochrane CG. Studies on the pathogenesis of the adult respiratory distress syndrome I. Journal of Clinical Investigation 69: 543–553, 1980Google Scholar
  65. Merritt TA, Hallman M, Bloom BT, Berry C, Benirschke K. Prophylactic treatment of very premature infants with human surfactant. New England Journal of Medicine 315: 785–790, 1986PubMedGoogle Scholar
  66. MerrittTA, Hallman M. Human Surfactant treatment of respiratory distress syndrome: recent experiences in prophylactic versus rescue treatment and an analysis of the role of SPA in surfactant function. Ross Laboratory Special Conference, p. 82, December 11–13, 1988bGoogle Scholar
  67. Merritt TA, Hallman M. Pediatric perspectives. American Journal of Diseases of Children 142: 1333–1339, 1988aPubMedGoogle Scholar
  68. Merritt TA, Revak S, Hallman M. Elastolytic degradation of surfactant 35kD apoprotein. Pediatric Research 21: 460A, 1987Google Scholar
  69. Merritt TA, Strayer DS, Hallman M, Wozinak P. Immunologie consequences of exogenous surfactant administration. Seminars in Perinatology 12: 221–230, 1988PubMedGoogle Scholar
  70. Metcalfe IL, Burgoyne R, Enhorning G. Surfactant supplementation in the preterm rabbit: effect of applied volumes on compliance and survival. Journal of Applied Physiology 16: 834–839, 1982Google Scholar
  71. Milner AD, Vyas GS, Hopkin IE. Effect of exogenous surfactant on total respiratory system compliance. Archives of Disease in Childhood 59: 398–401, 1984Google Scholar
  72. Milner AD, Vyas H, Hopkin EL Effects of artificial surfactant on lung function and blood gases in idiopathic respiratory distress syndrome. Archives of Disease of Childhood 58: 458, 1983Google Scholar
  73. Morley CJ, Bangham AD, Miller N, Davis JA. Dry artificial surfactant and its effects on very premature babies. Lancet 1: 64–67, 1981PubMedGoogle Scholar
  74. Nieman GF, Bredenberg CE. High surface tension pulmonary edema induced by detergent aerosol. Journal of Applied Physiology 58: 129–136, 1985PubMedGoogle Scholar
  75. Noack G, Berggren P, Curstedt T, Grossman G, Herin P, et al. Severe neonatal respiratory distress syndrome treated with isolated phospholipid fraction of natural surfactant. Acta Paediatrica Scandinavica 76: 697–705, 1987PubMedGoogle Scholar
  76. Nohara K, Muramatsu K, Oda T. Six cases of RDS treated with surfactant CK. J. Japan Med Soc Biol Interface 14: 173, 1983Google Scholar
  77. Notter RH. Biophysical behavior of lung surfactant: implications for respiratory physiology and pathophysiology. Seminars in Perinatology 8: 180–213, 1988Google Scholar
  78. Notter RH, Egan EA, Kwong MS, et al. Lung surfactant replacement in premature lambs with extracted lipids from bovine lung lavage: effects of dose, dispersion technique, and gestational age. Pediatric Research 19: 569–577, 1985PubMedGoogle Scholar
  79. Notter RH, Shapiro DL; Ohning B, Whitsett JA. Biophysical activity of synthetic phospholipids combined with purified lung surfactant 6,000 dalton apoprotein. Chemistry and Physics of Lipids 44: 1–17, 1987PubMedGoogle Scholar
  80. Obladen M, Brendlein F, Krempien B. Surfactant substitution. European Journal of Pediatrics 131: 219–228, 1979PubMedGoogle Scholar
  81. Ohta A, Muramatsu K, Oda T. A case of respiratory distress syndrome treated with surfactant CK. J. Japan Med Soc Biol Interface 12: 33, 1981Google Scholar
  82. Pattle RE. Properties, function and origin of the alveolar lining layer. Nature (London) 175: 1125–1126, 1955Google Scholar
  83. Phibbs RH. A preliminary report of initial trial of Exosurf, a synthetic surfactant, for the prevention and early treatment of hyaline membrane disease. Ross Laboratory Special Conference, p. 202, December 11–13, 1988Google Scholar
  84. Pierce J, Suelter CH. An evaluation of the Coomassie brillant blue G-250 dye-binding method for quantitative protein determination. Analytical Biochemistry 81: 478–480, 1977PubMedGoogle Scholar
  85. Possmayer F, Yu SH, Weber JM, Harding PGR. Pulmonary surfactant. Canadian Journal of Biochemistry and Cell Biology 62: 1121–1133, 1984PubMedGoogle Scholar
  86. Raju TNK, Bhat R, McCulloch KM, Maeta H, Vidyasagar D, et al. Double-blind controlled trial of single-dose treatment with bovine surfactant in severe hyaline membrane disease. Lancet 1: 651, 1987PubMedGoogle Scholar
  87. Rauvala H, Hallman M. Glycolipid accumulation in bronchoalveolar space in adult respiratory distress syndrome. Journal of Lipid Research 25: 1257–1262, 1984PubMedGoogle Scholar
  88. Richman PS, Spragg RG, Merritt TA, Robertson B, Curstedt T. Administration of porcine-lung surfactant to human with ARDS: initial experience. American Review of Respiratory Disease 135: A5, 1987Google Scholar
  89. Robertson B, Noack B, Bevilacqua G. Surfactant replacement in severe neonatal respiratory distress syndrome. In Vignali M et al. (Eds) Diagnosis and treatment of fetal lung immaturity, pp. 193–197, Massen Itali Editori, Milan, 1986Google Scholar
  90. Robillard E, Alarie Y, Dagenair-Perusse P, Baril E, Guilbeault A, et al. Microaerosol administration of synthetic-dipalmitoyllecithin in the respiratory distress syndrome: a preliminary report. Canadian Medical Association Journal 90: 55–57, 1964PubMedGoogle Scholar
  91. Schraufstatter IU, Hinshaw DB, Spragg RG, Cochrane CG. Oxidant injury of cells: DNA strand breaks activate poly-ADP-ribose polymerase and lead to depletion of nicotinamide adenine dinucleotide. Journal of Clinical Investigation 77: 1312–1320, 1986PubMedGoogle Scholar
  92. Seeger WG, Stohr G, Wolf HRD, Neuhof H. Alteration of surfactant function due to protein leakage: special interaction with fibrin monomer. Journal of Applied Physiology 58: 326–338, 1985PubMedGoogle Scholar
  93. Shapiro DL, Notter RH, Morin III FC. Double-blind randomized trial of a calf lung surfactant extract administered at birth to very premature infants for prevention of respiratory distress syndrome. Pediatrics 76: 593, 1985PubMedGoogle Scholar
  94. Shapiro D, Kendig J, Notter R, Reubens L, Cox C, et al. A multi-center randomized trial of preventilatory versus post-ventilatory administration of surfactant (Calf Lung Surfactant Extract). Ross Laboratory Special Conference, p. 105, December 11–13,1988Google Scholar
  95. Shelley SA, Paciga JE, Balis JU. Purification of surfactant from lung washings and washings contaminated with blood constituents. Lipids 12: 505–510, 1977PubMedGoogle Scholar
  96. Sherman MP, Campbell LA, Merritt TA, Shapiro D, Long W. The infected preterm rabbit lung: a model to test the efficacy of surfactant replacement on lung host defenses. Presented at the Third International Symposium, ‘Basic Research on Lung Surfactant’, Marburg, Germany, September 12–14, 1988Google Scholar
  97. Shimada S, Dyama K, Fujiwara T, Jain L, Vidyasager D. Hemo-dynamic changes in infants with RDS following surfactant therapy. Pediatric Research 29: 371, 1986Google Scholar
  98. Smyth JA, Metcalfe IL, Duffty P. Hyaline membrane disease treated with a bovine surfactant. Pediatrics 71: 913, 1983PubMedGoogle Scholar
  99. Smyth JA, Metcalfe IL, Duffty P. Surfactant therapy in hyaline membrane disease. Pediatric Research 15: 618A, 1981Google Scholar
  100. Soll RF, Hoekstra R, Fagman J, Corbet A, Adams J, et al. Multicenter trial of single dose Surfactant TA (STA) for prevention of respiratory distress syndrome (RDS). Abstract. Pediatric Research 23: 424, 1988Google Scholar
  101. Strayer DS, Merritt TA, Iweguga-Mukasa J, Hallman M. Surfactant-anti-surfactant immune complexes in infants with respiratory distress syndrome. American Journal of Pathology 122: 353–362, 1986PubMedGoogle Scholar
  102. Sznajer JI, Fraiman A, Crawford G, Hall J, Schmidt G, et al. Increased oxidant activity in expiratory breath of patients with hypoxemic respiratory failure. Abstract. American Review of Respiratory Disease 135: A264, 1987Google Scholar
  103. Taeusch W, Keough K, Williams M, Slavin R, Steele E, et al. Characterization of bovine surfactant (TA) for infants with RDS. Pediatrics 77: 572–581, 1986PubMedGoogle Scholar
  104. Takahashi A, Fujiwara T. Proteolipid in bovine lung surfactant: its role in surfactant function. Biochemical and Biophysical Research Communications 135: 527–532, 1986PubMedGoogle Scholar
  105. Ten Centre Study Group. Ten centre trial of artificial surfactant (artificial lung expanding compound) in very premature babies. British Medical Journal 294: 991–994, 1987Google Scholar
  106. Tooley WH, Clements JA, Muramatsu K, Brown CL, Schleuter MA. Lung function in prematurely delivered rabbits treated with a synthetic surfacant American Review of Respiratory Disease 136: 347–351, 1987Google Scholar
  107. Vaucher YE, Merritt TA, Hallman M, Jaarvenpaa AL. Neuro-developmental and respiratory outcome in early childhood following human surfactant treatment. American Journal of Diseases of Children 142: 927–930, 1988PubMedGoogle Scholar
  108. Vidyasagar D, Shimade S. Pulmonary surfactant replacement in respiratory distress syndrome. Clinics in Perinatology 14: 991–1015, 1987PubMedGoogle Scholar
  109. von Neergaard K. New concepts about a basis of breathing mechanism: the power of retraction of the lung dependent on surface tension in alveoli. Zeitschrift Gesellschaft Experimente Medizin 1929Google Scholar
  110. Walther FJ, Kuipers IM, Gidding CEM, Willebrand D, Buchholtz RTF. A comparison of high frequency oscillation superimposed onto backup mechanical ventilation and conventional mechanical ventilation on the distribution of exogenous surfactant in premature lambs. Pediatric Research 22: 725–729, 1987PubMedGoogle Scholar
  111. Weintraub Z, Sorokin Y, Flohr E. Surfactant replacement therapy for respiratory distress syndrome. In Jones CT & Nathanielsz PW (Eds) The physiological development of the fetus and newborn, p. 311, Academic Press, London, 1985Google Scholar
  112. Wilkinson A, Jenkins PA, Jeffrey JA. Two controlled trials of dry artificial surfactant: early effects and later outcome in babies with surfactant deficiency. Lancet 1: 287–291, 1985Google Scholar
  113. Wood BP, Sinken R, Kendig JW. Exogenous lung surfactant: effect on radiographie appearance in premature infants. Radiology 165: 11–13, 1987PubMedGoogle Scholar

Copyright information

© ADIS Press Limited 1989

Authors and Affiliations

  • T. Allen Merritt
    • 1
  • Mikko Hallman
    • 2
  • Roger Spragg
    • 3
  • Gregory P. Heldt
    • 1
  • Nicholas Gilliard
    • 3
  1. 1.Department of PediatricsUGSD School of MedicineSan DiegoUSA
  2. 2.Department of PediatricsUniversity of Helsinki, Children’s HospitalHelsinkiFinland
  3. 3.Department of MedicineUCSD School of MedicineSan DiegoUSA

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