ABSTRACT
This chapter summarizes the history and current status of clinical surfactant replacement therapy for RDS in premature infants. Coverage begins with early views and outcomes involving respiratory distress in premature infants in the 1950’s and extends through successful clinical trials of surfactant therapy in the 1980’s and 1990’s. The role of lung surfactant deficiency in RDS or hyaline membrane disease was suggested over four decades ago, but the pathophysiology of this disease was debated for some time. Initial unsuccessful therapy with aerosolized DPPC in premature infants in the 1960’s substantially delayed the development of clinically effective surfactant replacement interventions. Basic biophysical and animal model research emphasized in previous chapters was instrumental in establishing the foundation for successful exogenous surfactant therapy for premature infants. The results of clinical trials on the efficacy of surfactant therapy in premature infants are described in this chapter, along with ongoing efforts to optimize this treatment approach. Surfactant therapy in ARDS is covered in Chapter 13, and current and future clinical exogenous surfactants are detailed more fully in Chapter 14.
