A Comparison of Surfactant as Immediate Prophylaxis and as Rescue Therapy in Newborns of Less Than 30 Weeks' Gestation

EXOGENOUS pulmonary surfactants have been administered into the trachea both to prevent and to treat the respiratory distress syndrome in premature infants. Randomized clinical trials of surfactant-replacement therapy 1 2 3 4 5 6 7 8 9 10 11 12 13 14 have demonstrated a reduction in the incidence and severity of respiratory distress syndrome in infants born at less than 30 weeks' gestation. Two different strategies for the initiation of surfactant therapy have been used in these trials: a prophylactic approach 1 2 3 4 5 6 7 and a rescue approach. 8 9 10 11 12 13 14 When surfactant is used as prophylaxis, 1 2 3 4 5 6 7 it is administered in the delivery room either as soon as it is possible to intubate (immediate administration) or after a stabilization . . .