What is the role of surfactant replacement therapy in the prevention of pulmonary interstitial emphysema (PIE)?

Updated: Jun 25, 2019
  • Author: Abhay J Bhatt, MD, MBBS; Chief Editor: Muhammad Aslam, MD  more...
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Prophylactic surfactant administration to infants (< 30-32 weeks' gestation) judged to be at risk of developing respiratory distress syndrome (RDS) compared with selective use of surfactant in infants with established RDS has been demonstrated to decrease the risk of PIE. [48]

Meta-analysis of early surfactant replacement therapy with brief ventilation compared with later, selective surfactant replacement and continued mechanical ventilation suggests a trend toward a reduced incidence of air leak syndromes in premature infants in the early surfactant group. [49] Early surfactant treatment, less invasive ventilatory support, or both could be responsible factors for the observed beneficial trend. [49]

According to one report, in infants with RDS, multiple doses of animal-derived surfactant extract resulted in greater improvements in oxygenation and ventilatory requirements, a decreased risk of pneumothorax, and a trend toward improved survival. [50]

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