Lung surfactant and neonatal respiratory distress syndrome

This brief history of the observations that led to improvements in clinical management, and in many instances, prevention of respiratory distress syndrome, illustrates the power of multidisciplinary and multicenter approaches to medical problem-solving. The initial observations on surfactant deficiency in lungs of infants who died with atelectasis and hyaline membranes were supported from 1957 to 1959 by a special fellowship from the National Institute of Neurological Disease and Blindness to Avery, who was working as a research fellow with Mead at the Harvard School of Public Health. Through subsequent years the NHLBI supported the research at many centers that led to surfactant replacement therapy. Among the beneficiaries of this support were Clements and his colleagues at the University of California, San Francisco. Most of the later clinical trials in the United States were supported by Abbott-Ross Laboratories (Survanta), Burroughs Wellcome Company (Exosurf), and ONY and Forest Laboratories (Infasurf). In retrospect, the development of this field has been an exemplary story of cooperation among clinicians and scientists in government, academia, and industry. The benefits in knowledge gained, in lives saved, in suffering avoided, and in health care costs abated will last far into the future. Much credit for these advances belongs to the current and former members of the staff of the Lung Division of the NHLBI. On this celebration of the founding of the Pulmonary Program and the Lung Division, we salute them!.