Prophylactic treatment of very premature infants with human surfactant

T. A. Merritt, M. Hallman, B. T. Bloom, C. Berry, K. Benirschke, David Sahn, T. Key, D. Edwards, A. L. Jarvenpaa, M. Pohjavuori

Research output: Contribution to journalArticle

178 Citations (Scopus)

Abstract

We undertook a randomized, controlled trial to determine whether human surfactant administered endotracheally at birth to very premature infants (gestational age, 24 to 29 weeks) would prevent the respiratory distress syndrome or reduce its severity. Thirty-one treated infants (birth weight, 938 ± 286 g) were compared in a blinded fashion with 29 control infants (birth weight, 964 ± 174 g). The lecithin/sphingomyelin ratio was less than 2 in all infants, and phosphatidylglycerol was not present in amniotic fluid or tracheal fluids at birth, indicating a deficiency of surfactant in the lungs. The principal dependent variables were neonatal death, the incidence of bronchopulmonary dysplasia, and the infant's requirement for respiratory support (and its complications). The surfactant-treated group had significantly fewer deaths than the control group (16 percent vs. 52 percent, P <0.001), fewer cases of bronchopulmonary dysplasia (16 percent vs. 31 percent), and significantly fewer cases of pulmonary interstitial emphysema (P <0.001) and pneumothorax (P <0.02). Prophylactic treatment with human surfactant also substantially reduced the period of neonatal intensive care. We conclude that treatment with human surfactant offers promise for improving the survival of very premature infants with a surfactant deficiency and for reducing the pulmonary sequelae of the respiratory distress syndrome.

Original languageEnglish (US)
Pages (from-to)785-790
Number of pages6
JournalNew England Journal of Medicine
Volume315
Issue number13
StatePublished - 1986
Externally publishedYes

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Premature Infants
Surface-Active Agents
Bronchopulmonary Dysplasia
Birth Weight
Therapeutics
Parturition
Neonatal Intensive Care
Lung
Pulmonary Emphysema
Phosphatidylglycerols
Sphingomyelins
Lecithins
Pneumothorax
Amniotic Fluid
Gestational Age
Randomized Controlled Trials
Control Groups
Survival
Incidence

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Merritt, T. A., Hallman, M., Bloom, B. T., Berry, C., Benirschke, K., Sahn, D., ... Pohjavuori, M. (1986). Prophylactic treatment of very premature infants with human surfactant. New England Journal of Medicine, 315(13), 785-790.

Prophylactic treatment of very premature infants with human surfactant. / Merritt, T. A.; Hallman, M.; Bloom, B. T.; Berry, C.; Benirschke, K.; Sahn, David; Key, T.; Edwards, D.; Jarvenpaa, A. L.; Pohjavuori, M.

In: New England Journal of Medicine, Vol. 315, No. 13, 1986, p. 785-790.

Research output: Contribution to journalArticle

Merritt, TA, Hallman, M, Bloom, BT, Berry, C, Benirschke, K, Sahn, D, Key, T, Edwards, D, Jarvenpaa, AL & Pohjavuori, M 1986, 'Prophylactic treatment of very premature infants with human surfactant', New England Journal of Medicine, vol. 315, no. 13, pp. 785-790.
Merritt TA, Hallman M, Bloom BT, Berry C, Benirschke K, Sahn D et al. Prophylactic treatment of very premature infants with human surfactant. New England Journal of Medicine. 1986;315(13):785-790.
Merritt, T. A. ; Hallman, M. ; Bloom, B. T. ; Berry, C. ; Benirschke, K. ; Sahn, David ; Key, T. ; Edwards, D. ; Jarvenpaa, A. L. ; Pohjavuori, M. / Prophylactic treatment of very premature infants with human surfactant. In: New England Journal of Medicine. 1986 ; Vol. 315, No. 13. pp. 785-790.
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