Neonatal respiratory distress syndrome and surfactant therapy; a brief review.

Several randomized clinical trials have now documented a beneficial effect of surfactant replacement in established neonatal respiratory distress syndrome (RDS). These results have been obtained with surfactant isolated from animal lungs or human amniotic fluid. Treatment with exogenous natural surfactant usually reverses the clinical course of severe RDS, reduces the incidence of serious complications including bronchopulmonary dysplasia, and improves survival rate. Prophylactic surfactant treatment at birth reduces the incidence of severe RDS in very premature babies; this effect has been documented with natural as well as synthetic surfactant preparations. Increased incidence of patent ductus arteriosus was reported in one series of RDS patients treated with modified bovine surfactant, but otherwise no adverse effects have been observed.