SURFACTANT REPLACEMENT THERAPY FOR THE TREATMENT OF RESPIRATORY-DISTRESS SYNDROME

Surfactant replacement therapy for premature infants with respiratory distress syndrome (RDS) is one of the major advances in neonatal perinatal medicine during the past 20 years. The development of this new therapy is a result of many years of bench research, experimental trials in animal models of RDS, and multicenter randomized clinical trials in human infants at risk for developing RDS. Multicenter clinical trials have clearly shown the clinical effectiveness of surfactant replacement therapy in the form of reduction of the incidence of RDS, improvement in the survival rate of very low birth weight infants, and reduction in pulmonary complications resulting from RDS. However, the therapy does not influence the incidence of multisystem diseases such as intraventricular hemorrhage, bronchopulmonary dysplasia, patent ductus arteriosus, and necrotizing enterocolitis. Nevertheless, the availability of two surfactant preparations (Survanta and Exosurf Neonatal) have made an impact in the improvement in neonatal morbidity and mortality.