Abstract
We have studied lung function in 4 intubated and ventilated newborn infants with IRDS (birth-weights 1.1-1.47 kg, gest. age 26-29 w) immediately before and then repeatedly over 4 hours after instillation of human surfactant (100 mg/kg) into the endotrachealtubes. The infants were ventilated with max. insufflation pressures of 24-33 cml 120 and 4-10 cml 120 PEEP. Ventilatory flow was recorded by body plethysmography and FRC and ventilation efficiency by a N2 wash-out technique. Calculations were made by computer.In all infants FRC increased 20-120% within 10 min after treatment. Compliance of the respiratory system fell by 20-50%. Resistance was unaffected. Gas mixing improved over the first 30 min in 3/4. The changes in FRC and compliance returned within 45-90 min with a concomitant reduction of oxygenation. However, in 3/4 the need of oxygen or PEEP was persistantly reduced after treatment. We conclude that in these sick, ventilated infants with IRDS, the main effect of human surfactant in given doses was an immediate but transient increase of FRC that paralleled a fall in oxygen needs in 3/4. Supported by The Swedish Medical Research Council, Proj No. 5703.
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