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Pulmonary surfactant is used as a medication to treat and prevent respiratory distress syndrome in newborn babies. [1] Prevention is generally done in babies born at a gestational age of less than 32 weeks. [1] It is given by the endotracheal tube. [1] Onset of effects is rapid. [2] A number of doses may be needed. [2]
Infant respiratory distress syndrome (IRDS), also known as surfactant deficiency disorder (SDD), [2] and previously called hyaline membrane disease (HMD), is a syndrome in premature infants caused by developmental insufficiency of pulmonary surfactant production and structural immaturity in the lungs.
Conditions adult respiratory distress syndrome or Hyaline Membrane Disease are also sometimes treated with exogenously derived surfactant. One of the more common uses of surfactant therapy is to treat alveolar surfactant deficiency in premature newborns. Most commonly, treatment is composed of multiple doses of 100 mg/kg of exogenous surfactant ...
Testing for surfactant metabolism dysfunction should be considered for newborns with diffuse lung disease or hypoxemia, especially in families with history of neonatal lung diseases or ILD in adults. Neonatal and adult onset lung diseases with unfound causes should also be tested early for surfactant dysfunction. [ 3 ]
Transient tachypnea of the newborn occurs in approximately 1 in 100 preterm infants and 3.6–5.7 per 1000 term infants. It is most common in infants born by caesarian section without a trial of labor after 35 weeks of gestation. Male infants and infants with an umbilical cord prolapse or perinatal asphyxia are at higher risk.
Infant respiratory distress syndrome is the leading cause of death in preterm infants, [29] and the main treatments are CPAP, in addition to administering pulmonary surfactant and stabilizing the blood sugar, blood salts, and blood pressure.
Beractant, also known by the trade name of Survanta, is a modified bovine pulmonary surfactant containing bovine lung extract (phospholipids, neutral lipids, fatty acids, and bovine surfactant proteins), to which synthetic DPPC, tripalmitin and palmitic acid are added.
[12] [13] The discovery that the treatment effect was dependent on the surfactant preparation containing natural surfactant proteins and that the surfactant was administered as a bolus dose directly into the trachea, was a fine discovery, i.e. to be effective the treatment needed to be nebulised directly into the lungs of preterm infants, [2 ...