[Treatment of severe respiratory distress syndrome in the premature infant with natural surfactant].

14 preterm infants with severe respiratory distress syndrome (birthweight 1170 +/- 369 g, mean +/- 1SD) have been treated with a single dose of natural porcine surfactant (Curosurf, 200 mg/kg); follow up and outcome data were compared with matched controls (1200 +/- 288 g, n = 20). Treated infants showed improved oxygenation and gas exchange within minutes after surfactant application. Duration of intermittent positive pressure ventilation was significantly reduced in treated patients when compared to controls (surfactant treated: 16 d (mean value), controls 27 d, p less than 0.05). Similarly, total exposition in greater than 40% oxygen was 5.5 h in treated infants versus 79 h in controls (p less than 0.001). Pneumothorax occurred in 7 of the 20 control infants (35%), but in none of the treated patients (p less than 0.05). However, haemodynamically significant patent ductus arteriosus (PDA) occurred more often in the surfactant group (50% versus 30%, not significant). The incidence of PDA requiring treatment was the same in both groups. Occurrence of intracranial haemorrhage, bronchopulmonary dysplasia and retinopathy of prematurity was identical in both groups. Mortality was 25% in controls and 7% in treated babies. This study confirms the efficacy of surfactant treatment in neonates with severe respiratory distress syndrome.