PEDIATRICS Vol. 92 No. 1 July 1993, pp. 148-150
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Surfactant Replacement Therapy: Prophylaxis or Treatment?

MICHAEL S. DUNN MD, FRCP1

1 Dept of Newborn and Developmental Paediatrics, Women's College Hospital, University of Toronto Perinatal Complex, Toronto, Ontario, Canada

After extensive preclinical and clinical testing, surfactant replacement therapy for premature neonates has become routine in modern neonatal intensive care units. Even though "everyone's doing it," there is nevertheless wide variation in how this therapy is applied. Future studies will be needed to help sort out some of the unresolved issues such as the best preparation, optimal delivery method, how best to ventilate the surfactant-treated neonate, when to retreat with surfactant, and the role of adjunctive therapies such as indomethacin or corticosteroids.

Considerable controversy also exists over when surfactant should be administered. This issue has been studied in some depth, both in animals and premature neonates.

Submitted on April 15, 1993
Accepted on April 16, 1993