THE LUNGS IN IMMATURE INFANTS - HOW IMPORTANT IS SURFACTANT THERAPY IN PREVENTING CHRONIC LUNG PROBLEMS

Seventy-five premature infants weighing between 600 and 3200 g were st udied over a period of 1 year. All of the infants received surfactant therapy for hyaline membrane disease immediately after birth and, ther eafter, up to four doses every 6 h. The roentgenographic findings in a ll patients were documented at birth and at 2 days, 7-10 days, and 21- 28 days of life. Larger babies responded to surfactant therapy better than did smaller infants. The smaller infants, even after initial clea ring, were prone to develop pulmonary edema and the bubbly lungs of br onchopulmonary dysplasia. These data suggest that small infants, while initially responding to surfactant therapy with clearing of their lun gs, are still at considerable risk of developing chronic lung disease in the form of pulmonary edema and bronchopulmonary dysplasia. An expl anation is offered for why this occurs; at the same time it is suggest ed that, in view of our findings and those in the literature, the prob lems of pulmonary edema and bubbly lungs be more clearly separated.