Effects of exogenous surfactant therapy on dynamic compliance during mechanic breathing in preterm infants with hyaline membrane disease

Surfactant is a type of lipoprotein that allows the exchange of gases in the lungs and contributes to the elasticity of the pulmonary tissue by reducing the surface tension of pulmonary fluids. Hyaline membrane disease is a serious lung condition of premature newborns characterized by inelastic lungs and very rapid respirations. Infants with hyaline membrane disease are deficient in this lipoprotein and either die within a few days of birth, or recover with no aftereffects. These babies often require mechanical ventilation. In animal studies, surfactant replacement therapy has been shown to improve lung compliance and gas exchange. There is limited data on humans concerning the use of surfactant. In this study, 94 preterm infants, weighing between 1 lb 5 oz and 2 lbs 12 oz. (600 and 1,250 grams), who were dependent on mechanical respiration received either exogenous surfactant or air therapy in the delivery room and three times afterward during the first 48 hours of life. Pulmonary mechanics assessment was performed. At 24 hours of age, there was a 50 percent greater dynamic compliance in the surfactant group, than in the group receiving air. At seven days of age the difference between the two groups was 94 percent greater dynamic compliance for the surfactant group. Oxygenation was sufficiently greater in the surfactant group during the first three days of life. The findings indicate that exogenous surfactant therapy in preterm infants with hyaline membrane disease can be helpful in improving pulmonary mechanics (dynamic compliance) and gas exchange during mechanical respiration. (Consumer Summary produced by Reliance Medical Information, Inc.)