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Lung Diseases: Surfactant Replacement Therapy

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Neonatology

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Abstract

In the past 3 decades introduction of prenatal steroid treatment, postnatal surfactant therapy and assisted ventilation have lead directly to improved neonatal outcomes [1]. Improved survival is directly related to more effective prevention or treatment of respiratory distress syndrome (RDS), which prior to the 1990s had a high mortality. Following unsuccessful clinical trials with nebulized synthetic surfactants, comprised of phospholipids without surfactant proteins, in the 1960s [2] a number of randomized controlled trials in the 1980s demonstrated benefits of surfactants instilled directly into the lungs of preterm infants [3–5]. These surfactants were of 2 main types: natural (derived from animal lungs or human amniotic fluid) [3] containing surfactant proteins-B and C (SP-B and SP-C) and synthetic [4, 5] (containing phospholipids and other agents to facilitate spreading and adsorption). Both types of surfactant given, either prophylactically (in the delivery room within 15 minutes of birth) [3, 4] or for treatment of RDS [5], increased neonatal survival and reduced pulmonary air leaks such as pneumothoraces and pulmonary interstitial emphysema.

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Author information

Authors and Affiliations

  1. Regional Neonatal Unit, Royal Maternity Hospital, Belfast, Northern Ireland

    Henry L. Halliday

  2. Department of Child Health, Queen’s University Belfast, Belfast, Northern Ireland

    Henry L. Halliday

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  1. Henry L. Halliday
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Editors and Affiliations

  1. Department of Pediatrics, Obstetrics and Reproductive Medicine, Division of Neonatology, University of Siena General Hospital S. Maria alle Scotte Azienda Ospedaliera Universitaria Senese, Siena, Italy

    Giuseppe Buonocore (Professor of Pediatrics and Neonatology, Head of School of Pediatrics) (Professor of Pediatrics and Neonatology, Head of School of Pediatrics)

  2. University of Siena, Siena, Italy

    Rodolfo Bracci (Formerly Professor of Pediatrics and Head of Department of Pediatrics, Obstetrics and Reproductive Medicine) (Formerly Professor of Pediatrics and Head of Department of Pediatrics, Obstetrics and Reproductive Medicine)

  3. University of Liverpool, UK

    Michael Weindling (Professor of Perinatal Medicine, Director of Postgraduate Research, Head of School of Paediatrics Mersey Deanery) (Professor of Perinatal Medicine, Director of Postgraduate Research, Head of School of Paediatrics Mersey Deanery)

  4. Department of Women’s and Children’s Health, Institute of Translational Medicine, Liverpool, UK

    Michael Weindling (Professor of Perinatal Medicine, Director of Postgraduate Research, Head of School of Paediatrics Mersey Deanery) (Professor of Perinatal Medicine, Director of Postgraduate Research, Head of School of Paediatrics Mersey Deanery)

  5. Liverpool Women’s Hospital, Liverpool, UK

    Michael Weindling (Professor of Perinatal Medicine, Director of Postgraduate Research, Head of School of Paediatrics Mersey Deanery) (Professor of Perinatal Medicine, Director of Postgraduate Research, Head of School of Paediatrics Mersey Deanery)

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© 2012 Springer-Verlag Italia

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Halliday, H.L. (2012). Lung Diseases: Surfactant Replacement Therapy. In: Buonocore, G., Bracci, R., Weindling, M. (eds) Neonatology. Springer, Milano. https://doi.org/10.1007/978-88-470-1405-3_70

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  • DOI: https://doi.org/10.1007/978-88-470-1405-3_70

  • Publisher Name: Springer, Milano

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