Use of surfactant in neonatal intensive care units

M Sholeh Kosim

doi:10.14238/pi45.6.2005.233-40

M Sholeh Kosim

DOI: https://doi.org/10.14238/pi45.6.2005.233-40

Keywords: surfactant, neonatal intensive care units

Abstract

Surfactant is currently an important therapy
for newborns in neonatal intensive care units
(NICUs) with respiratory problems,
specifically respiratory distress syndrome
(RDS). Surfactant was initially used in 1959, after it
was recognized for maintaining lung inflation at low
transpulmonary pressures. Avery and Mead in Jobe
reported that saline extracts from the lungs of
preterm infants with RDS lacked the low surface
tension characteristics of pulmonary surfactant.
Subsequently, in 1980, clinical potential of surfactant
therapy for RDS was demonstrated by Fujiwara et al,
reported in Jobe, in the use of surfactant prepared
from an organic solvent extracted from bovine lung
(Surfactant TA). Small randomized controlled trials
(RCTs) in 1985, which tested surfactants prepared
from bovine alveolar-lavage or human amniotic fluid,
demonstrated significant decrease in pneumothorax
and death rates. Subsequent multi-center trials
demonstrated decreased death rates and
complications of RDS; although still investigational,
its use begun in 1989. A synthetic surfactant was
approved for the treatment of the syndrome in the
United States in 1990, and an animal surfactant was
approved in 1991. These surfactants represent a new
class of drug developed specifically for preterm
infants.

Author Biography

M Sholeh Kosim

Department of Child Health, Medical School, Diponegoro
University, Kariadi Hospital, Semarang, Indonesia.

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