PULMONARY SURFACTANT DYSFUNCTION IN CONGENITAL DIAPHRAGMATIC-HERNIA -EXPERIMENTAL AND CLINICAL FINDINGS

Experimental and clinical findings indicate immaturity of pulmonary su rfactant in congenital diaphragmatic hernia (CDH). Lung histology has shown a decreased amount of lamellar bodies. A low lecithin/sphingomye lin ratio in the amniotic fluid, and decreased concentrations of surfa ctant protein A and disaturated phosphatidylcholine in the pulmonary t issue and the amniotic fluid have been reported. Furthermore, low comp liance and high surface tension have also been found, Evidence of clin ical and experimental findings of structural, biochemical and function al pulmonary immaturity in CDH is reviewed. Prenatal administration of corticosteroids to accelerate fetal pulmonary maturation, and the use of early surfactant therapy, should be further evaluated in the clini cal management of CDH.