Surfactant Replacement Therapy in Newborns with Hyaline Membrane Disease

1992 ◽  
Vol 4 (3) ◽  
pp. 515-520
Author(s):  
Diana W. Grobman ◽  
Mary M. Foley
Keyword(s):  
Replacement Therapy ◽  
Hyaline Membrane Disease ◽  
Surfactant Replacement ◽  
Surfactant Replacement Therapy ◽  
Hyaline Membrane

scholarly journals Outcome of Surfactant Replacement Therapy in Preterm Babies with Hyaline Membrane Disease at Neonatal Intensive Care Unit of a Tertiary Hospital

2019 ◽  
Vol 3 (3) ◽  
pp. 537-541
Author(s):  
Sunil Raja Manandhar
Keyword(s):  
Birth Weight ◽  
Replacement Therapy ◽  
Gestational Age ◽  
College Teaching ◽  
Hyaline Membrane Disease ◽  
Medical College ◽  
Surfactant Replacement ◽  
Surfactant Replacement Therapy ◽  
Hyaline Membrane ◽  
Preterm Babies

Introduction: Hyaline membrane disease (HMD) is an acute lung disease of preterm babies caused by surfactant insufficiency. Decreased surfactant results in insufficient surface tension in the alveolus during expiration leading to alveolar collapse, atelectasis, impaired gas exchange, severe hypoxia and acidosis, leading to respiratory failure. Surfactant replacement therapy (SRT) is now accepted as the standard treatment of preterm babies with HMD. Objective: The objective of this study was to analyze the outcome of surfactant replacement therapy in preterm babies with hyaline membrane disease. Methodology: This is a prospective observational study conducted at 10 bedded neonatal unit of Pediatrics Department, Kathmandu Medical College Teaching Hospital, Sinamangal. Study duration was of one year period (15 May 2017 – 14 May 2018). Preterm babies from 26 wks–35 wks of gestation with Hyaline Membrane Disease were included in this study whereas babies with lethal congenital malformations eg: Meningomyelocele, Anencephaly, Gastrochisis, Diaphragmatic Hernia were excluded. All preterm babies who had clinical and radiological features of HMD were considered for Surfactant Replacement Therapy (SRT). The surfactant (Survanta; Abboti Laboratories, USA; Dose: 4 ml/kg) was administered intra-tracheally according to standard procedures in four divided aliquot applying INSURE (intubation, surfactant administration and extubation to Bubble CPAP) Technique. Ethical clearance was received from Institutional Review Committee (IRC) of Kathmandu Medical College and Statistical analysis was done with SPSS 19 version with frequency and cross tabulation. Results: In this study of 30 preterm babies with HMD received SRT, 47% (14) were male and 53% (16) were female. The mean birth weight of preterm babies with HMD was 1372.17 ± 395 gms and mean gestational age was 30.1±2.6 weeks. Among 30 preterm babies with HMD receiving SRT, 73.3% (22 babies) discharged from the hospital and 6.3% (8 babies) expired. Among eight expired babies, five died due to pulmonary hemorrhage and three died due to septicemia with DIC. Maximum survival was seen in the gestational age of 30-35 wks and birth weight 1200-2100gms. Conclusion: The use of SRT has improved the survival outcome and decreased the associated morbidities in babies with HMD. The maximum impact of survival was seen among the preterm babies of 30- 35 weeks with birth weight of 1200 -2100 grams. 

Surfactant replacement therapy in utero for prevention of hyaline membrane disease in the preterm baboon

1993 ◽  
Vol 169 (4) ◽  
pp. 817-824 ◽  
Author(s):  
Henry L. Galan ◽  
Cheryl Cipriani ◽  
Jacqueline J. Coalson ◽  
Jolene D. Bean ◽  
Gerald Collier ◽  
...  
Keyword(s):  
Replacement Therapy ◽  
Hyaline Membrane Disease ◽  
In Utero ◽  
Surfactant Replacement ◽  
Surfactant Replacement Therapy ◽  
Hyaline Membrane

scholarly journals Veno-venous ECMO as a platform to evaluate lung lavage and surfactant replacement therapy in an animal model of severe ARDS

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Robert Qaqish ◽  
Yui Watanabe ◽  
Marcos Galasso ◽  
Cara Summers ◽  
A adil Ali ◽  
...  
Keyword(s):  
Replacement Therapy ◽  
Lung Lavage ◽  
Post Injury ◽  
Surfactant Replacement ◽  
Recruitment Maneuvers ◽  
Surfactant Replacement Therapy ◽  
Dosing Strategies ◽  
Yorkshire Pigs ◽  
Saline Lavage ◽  
Protective Systems

Abstract Background There are limited therapeutic options directed at the underlying pathological processes in acute respiratory distress syndrome (ARDS). Experimental therapeutic strategies have targeted the protective systems that become deranged in ARDS such as surfactant. Although results of surfactant replacement therapy (SRT) in ARDS have been mixed, questions remain incompletely answered regarding timing and dosing strategies of surfactant. Furthermore, there are only few truly clinically relevant ARDS models in the literature. The primary aim of our study was to create a clinically relevant, reproducible model of severe ARDS requiring extracorporeal membrane oxygenation (ECMO). Secondly, we sought to use this model as a platform to evaluate a bronchoscopic intervention that involved saline lavage and SRT. Methods Yorkshire pigs were tracheostomized and cannulated for veno-venous ECMO support, then subsequently given lung injury using gastric juice via bronchoscopy. Animals were randomized post-injury to either receive bronchoscopic saline lavage combined with SRT and recruitment maneuvers (treatment, n = 5) or recruitment maneuvers alone (control, n = 5) during ECMO. Results PaO2/FiO2 after aspiration injury was 62.6 ± 8 mmHg and 60.9 ± 9.6 mmHg in the control and treatment group, respectively (p = 0.95) satisfying criteria for severe ARDS. ECMO reversed the severe hypoxemia. After treatment with saline lavage and SRT during ECMO, lung physiologic and hemodynamic parameters were not significantly different between treatment and controls. Conclusions A clinically relevant severe ARDS pig model requiring ECMO was established. Bronchoscopic saline lavage and SRT during ECMO did not provide a significant physiologic benefit compared to controls.

Surfactant Replacement Therapy and the Prevalence of Acute Retinopathy of Prematurity

Neonatology ◽  
1992 ◽  
Vol 61 (1) ◽  
pp. 54-58 ◽  
Author(s):  
Richard J. Tubman ◽  
Simon J. Rankin ◽  
Henry L. Halliday ◽  
Stewart S. Johnston
Keyword(s):  
Replacement Therapy ◽  
Retinopathy Of Prematurity ◽  
Surfactant Replacement ◽  
Surfactant Replacement Therapy

Surfactant Replacement Therapy in Preterm Infants: A European Survey

Neonatology ◽  
2011 ◽  
Vol 100 (1) ◽  
pp. 71-77 ◽  
Author(s):  
Anton H. van Kaam ◽  
Anne P. De Jaegere ◽  
Dorine Borensztajn ◽  
Peter C. Rimensberger
Keyword(s):  
Replacement Therapy ◽  
Preterm Infants ◽  
Surfactant Replacement ◽  
European Survey ◽  
Surfactant Replacement Therapy

A Different View of Surfactant Development

PEDIATRICS ◽  
1992 ◽  
Vol 89 (1) ◽  
pp. 173-174
Author(s):  
RODERIC H. PHIBBS
Keyword(s):  
Clinical Trials ◽  
Replacement Therapy ◽  
Hyaline Membrane Disease ◽  
Hyaline Membrane

In Reply.— Dr Kattwinkel suggests in his letter that there has been no serious effort by investigators in neonatology and pulmonary biology to identify the best possible surfactant for use for replacement therapy in hyaline membrane disease. Furthermore, he implies that there has been a national or perhaps international conspiracy to ignore natural human surfactant in the large clinical trials done to date. In reaching these opinions, Dr Kattwinkel seems to have ignored several facts of which he should be aware.

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