Abstract
The function of pulmonary surfactant of a group of 14 preterm neonates (birth weight 907 ± 60 g) who suffered from severe respiratory distress syndrome (RDS) and who had received exogenous bovine lipid extracted surfactant on the first day of life was compared to that in a second group of 8 neonates (birth weight 940 ± 110 g) with mild RDS who had not received surfactant treatment. Mechanical respiratory support from day 2 on was the same in both groups. The minimal surface tension (γ<sub>min</sub>) improved steadily, falling from about 30 mN/m initially to less than 20 mN/m before extubation. A consistent but loose correlation was found between γ<sub>min</sub> and mechanical respiratory support necessary, as quantitated by the oxygenation index. Total protein was about 0.8 ± 0.2 mg/mg of phospholipids and did not change during the first week of life. There were no correlations between total protein and γ<sub>min</sub> or the oxygenation index. The data suggest that inhibition of surfactant function by proteins leaked into the airspaces does not play a major role during recovery from RDS. Instead, endogenous remodelling of surfactant might be of greater relevance.
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