PEDIATRICS Vol. 81 No. 2 February 1988, pp. 277-283
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Early and Late Surfactant Treatments in Baboon Model of Hyaline Membrane Disease

Haruo Maeta MD1, Dharmapuri Vidyasagar MD1, Tonse N. K. Raju MD1, Rama Bhat MD1, and Hiroo Matsuda MD1

1 From the Department of Pediatrics, University of Illinois at Chicago Medical Center, Chicago

Because the issue of optimal time for artificial surfactant therapy for hyaline membrane disease has not been established, the effects of treatment with a reconstituted bovine surfactant (surfactant TA) were compared at two time periods in a hyaline membrane disease model in a premature baboon. The baboons were delivered by cesarian section at 75% of gestation (139.5 ± 1.5 days, mean ± SD). One group was treated with surfactant TA within ten minutes after birth (ultraearly), another group was treated at two hours of age (late) and a third (comparison group) did not receive the surfactant. Both treatment groups had significantly higher compliance and ratio of arterial to alveolar Po2 ratio and lower mean airway pressure and oxygen requirement (Fio2) than the comparison group. At autopsy, the largest residual volume and hysteresis in pulmonary pressure-volume curves were noted in the ultraearly group, intermediate values were found in the late group, and least values were found in the comparison group. These data indicate that early surfactant therapy for hyaline membrane disease results in greater improvement in lung mechanics than delaying treatment, even for two hours. Delivery room treatment with surfactant of infants at risk for hyaline membrane disease is perhaps better than therapy for established hyaline membrane disease.

Key Words: hyaline membrane disease • pulmonary surfactant • prematurity • newborn

Submitted on August 25, 1986
Accepted on March 25, 1987




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