Abstract
Since it has been demonstrated that hyaline membrane disease (HMD) is due to a relative deficiency of lung surfactant,1,2 one possible approach to the treatment or prevention of HMD in premature infants might be the introduction of surfactant into the lungs. Thus far, attempts at aerosolization of either synthetic surfactant (dipalmitoyl lecithin [DPL]) or natural surfactant into the lungs of patients or animals have failed to produce convincing benefits.3-5 On the other hand, direct instillation of a solution of natural surfactant into the trachea seems to produce striking results. Enhörning et al6 were the first to show that tracheal deposition of natural surfactant into premature rabbit fetuses before the first breath enhanced air intake and improved the pressure-volume relationships of the lungs; it also increased their survival time.7
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