Clinical trials and pilot studies on exogenous surfactant supplementation

• Neonates with lung injury not related to prematurity

  • Meconium Aspiration Syndrome
    • Bolus instillation

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Bolus surfactant instillation has been described as a possible treatment by several authors in uncontrolled clinical trials. The efficacy of the method has not been unanimously accepted due to the presence of meconium in the airways and the possibility to deteriorate the lung patency by instilling a cremous liquid (surfactant). Moreover, surfactant administered can be rapidly inactivated by the large quantity of existing meconium.

Halliday et al. have demonstrated that the treatment may be useful in some specific conditions. The variety of lung damage (obstruction, chemical pneumonia, production of large quantities of inhibitors) may be determinant in the final result of surfactant supplementation.

Auten R, Notter RH, Kending JW, Davis JM, Shapiro DL. Pediatrics 1991

Khammash H, Pearlman M, Wojtulewicz J, Dunn M. Pediatrics 1993

Marraro G. Cah Anesthesiol 1994

Halliday HL, Speer c, Robertson B on behalf of the collaborative Surfactant Study Group. Eur J Pediatr 1996

Lotze A, Mitchell BR, Bulas DI, Hull WM, O’Donnell RM, Whisett JA, Short BL, Zola EM, Shalwitz RA, Gunkel JH. J Pediatr 1998;132:40-47