ABSTRACT
This book is about the description, pathogenesis, treatment, prevention, and outcomes of infants with bronchopulmonary dysplasia (BPD). The single most important new therapy available for the highest-risk infants (small and immature) is surfactant treatment for respiratory distress syndrome (RDS). Surfactant treatments are the most thoroughly studied therapy in neonatology. The results of over 40 excellent randomized, controlled trails that include thousands of infants have been published. It would seem to be straightforward to answer the question if surfactant prevents BPD because this outcome was consistently recorded as a primary outcome variable in the clinical trials. However, several factors complicate a simple answer to the question. My goals are to present the clinical data, develop the arguments why surfactant therapy should decrease BPD, ask why surfactant might not decrease BPD, and finally, try to answer the question. This chapter is written from the perspective of a commentary or editorial because there is no consensus on the effects of surfactant on BPD.
