Factors associated with surfactant treatment response in infants with severe respiratory distress syndrome

A. Charon, H. W. Taeusch, C. Fitzgibbon, G. B. Smith, S. T. Treves, David Phelps

Research output: Contribution to journalArticle

75 Citations (Scopus)

Abstract

In a prospective, randomized study of 18 infants treated with bovine surfactant (surfactant TA, Tokyo Tanabe Co, Tokyo) for severe respiratory distress syndrome, a lasting response was found in 12 infants (66%) a transient response was found in two (11%), and no response was found in four (22%) when arterial to alveolar PO2 ratios were used to define responses during the first 48 hours after treatment. In contrast, three of 23 control infants (13%) had a transient or lasting 'response' to sham treatment (Pediatrics 1987;79:31-37). To determine whether maldistribution of surfactant could explain lack of response or a transient response, surfactant TA was mixed with technetium-99m sulfur colloid (approximately 300 μCi per infant), and eight infants with severe respiratory distress syndrome were treated six to 58 hours after birth. Scintigraphy of the lungs was performed three to 15 hours after treatment. Although a lasting response was observed in three infants, a transient one in three, and no response in two, no gross maldistribution of the radioactive label was found. Either lung received from 37% to 62% of the total radioactivity. During the past 3 years, in all infants with severe respiratory distress syndrome who were treated with surfactant (n = 29), poor or transient responses were associated with early patent ductus arteriosus and air leaks (pulmonary interstitial emphysema and pneumothoraces). Pathophysiologic conditions associated with respiratory distress syndrome are more likely to explain suboptimal responses after surfactant treatment than gross maldistribution of surfactant in the lungs.

Original languageEnglish (US)
Pages (from-to)348-354
Number of pages7
JournalPediatrics
Volume83
Issue number3
StatePublished - Jan 1 1989

Fingerprint

Surface-Active Agents
Tokyo
Lung
Therapeutics
Technetium Tc 99m Sulfur Colloid
Pulmonary Emphysema
Patent Ductus Arteriosus
Technetium
Pneumothorax
Radionuclide Imaging
Radioactivity
Air
Placebos
Parturition
Prospective Studies
Pediatrics

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

Charon, A., Taeusch, H. W., Fitzgibbon, C., Smith, G. B., Treves, S. T., & Phelps, D. (1989). Factors associated with surfactant treatment response in infants with severe respiratory distress syndrome. Pediatrics, 83(3), 348-354.
Charon, A. ; Taeusch, H. W. ; Fitzgibbon, C. ; Smith, G. B. ; Treves, S. T. ; Phelps, David. / Factors associated with surfactant treatment response in infants with severe respiratory distress syndrome. In: Pediatrics. 1989 ; Vol. 83, No. 3. pp. 348-354.
@article{6aab10f6bbba4dc9b2e448c3dbc05b7b,
title = "Factors associated with surfactant treatment response in infants with severe respiratory distress syndrome",
abstract = "In a prospective, randomized study of 18 infants treated with bovine surfactant (surfactant TA, Tokyo Tanabe Co, Tokyo) for severe respiratory distress syndrome, a lasting response was found in 12 infants (66{\%}) a transient response was found in two (11{\%}), and no response was found in four (22{\%}) when arterial to alveolar PO2 ratios were used to define responses during the first 48 hours after treatment. In contrast, three of 23 control infants (13{\%}) had a transient or lasting 'response' to sham treatment (Pediatrics 1987;79:31-37). To determine whether maldistribution of surfactant could explain lack of response or a transient response, surfactant TA was mixed with technetium-99m sulfur colloid (approximately 300 μCi per infant), and eight infants with severe respiratory distress syndrome were treated six to 58 hours after birth. Scintigraphy of the lungs was performed three to 15 hours after treatment. Although a lasting response was observed in three infants, a transient one in three, and no response in two, no gross maldistribution of the radioactive label was found. Either lung received from 37{\%} to 62{\%} of the total radioactivity. During the past 3 years, in all infants with severe respiratory distress syndrome who were treated with surfactant (n = 29), poor or transient responses were associated with early patent ductus arteriosus and air leaks (pulmonary interstitial emphysema and pneumothoraces). Pathophysiologic conditions associated with respiratory distress syndrome are more likely to explain suboptimal responses after surfactant treatment than gross maldistribution of surfactant in the lungs.",
author = "A. Charon and Taeusch, {H. W.} and C. Fitzgibbon and Smith, {G. B.} and Treves, {S. T.} and David Phelps",
year = "1989",
month = "1",
day = "1",
language = "English (US)",
volume = "83",
pages = "348--354",
journal = "Pediatrics",
issn = "0031-4005",
publisher = "American Academy of Pediatrics",
number = "3",

}

Charon, A, Taeusch, HW, Fitzgibbon, C, Smith, GB, Treves, ST & Phelps, D 1989, 'Factors associated with surfactant treatment response in infants with severe respiratory distress syndrome', Pediatrics, vol. 83, no. 3, pp. 348-354.

Factors associated with surfactant treatment response in infants with severe respiratory distress syndrome. / Charon, A.; Taeusch, H. W.; Fitzgibbon, C.; Smith, G. B.; Treves, S. T.; Phelps, David.

In: Pediatrics, Vol. 83, No. 3, 01.01.1989, p. 348-354.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Factors associated with surfactant treatment response in infants with severe respiratory distress syndrome

AU - Charon, A.

AU - Taeusch, H. W.

AU - Fitzgibbon, C.

AU - Smith, G. B.

AU - Treves, S. T.

AU - Phelps, David

PY - 1989/1/1

Y1 - 1989/1/1

N2 - In a prospective, randomized study of 18 infants treated with bovine surfactant (surfactant TA, Tokyo Tanabe Co, Tokyo) for severe respiratory distress syndrome, a lasting response was found in 12 infants (66%) a transient response was found in two (11%), and no response was found in four (22%) when arterial to alveolar PO2 ratios were used to define responses during the first 48 hours after treatment. In contrast, three of 23 control infants (13%) had a transient or lasting 'response' to sham treatment (Pediatrics 1987;79:31-37). To determine whether maldistribution of surfactant could explain lack of response or a transient response, surfactant TA was mixed with technetium-99m sulfur colloid (approximately 300 μCi per infant), and eight infants with severe respiratory distress syndrome were treated six to 58 hours after birth. Scintigraphy of the lungs was performed three to 15 hours after treatment. Although a lasting response was observed in three infants, a transient one in three, and no response in two, no gross maldistribution of the radioactive label was found. Either lung received from 37% to 62% of the total radioactivity. During the past 3 years, in all infants with severe respiratory distress syndrome who were treated with surfactant (n = 29), poor or transient responses were associated with early patent ductus arteriosus and air leaks (pulmonary interstitial emphysema and pneumothoraces). Pathophysiologic conditions associated with respiratory distress syndrome are more likely to explain suboptimal responses after surfactant treatment than gross maldistribution of surfactant in the lungs.

AB - In a prospective, randomized study of 18 infants treated with bovine surfactant (surfactant TA, Tokyo Tanabe Co, Tokyo) for severe respiratory distress syndrome, a lasting response was found in 12 infants (66%) a transient response was found in two (11%), and no response was found in four (22%) when arterial to alveolar PO2 ratios were used to define responses during the first 48 hours after treatment. In contrast, three of 23 control infants (13%) had a transient or lasting 'response' to sham treatment (Pediatrics 1987;79:31-37). To determine whether maldistribution of surfactant could explain lack of response or a transient response, surfactant TA was mixed with technetium-99m sulfur colloid (approximately 300 μCi per infant), and eight infants with severe respiratory distress syndrome were treated six to 58 hours after birth. Scintigraphy of the lungs was performed three to 15 hours after treatment. Although a lasting response was observed in three infants, a transient one in three, and no response in two, no gross maldistribution of the radioactive label was found. Either lung received from 37% to 62% of the total radioactivity. During the past 3 years, in all infants with severe respiratory distress syndrome who were treated with surfactant (n = 29), poor or transient responses were associated with early patent ductus arteriosus and air leaks (pulmonary interstitial emphysema and pneumothoraces). Pathophysiologic conditions associated with respiratory distress syndrome are more likely to explain suboptimal responses after surfactant treatment than gross maldistribution of surfactant in the lungs.

UR - http://www.scopus.com/inward/record.url?scp=0024515471&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0024515471&partnerID=8YFLogxK

M3 - Article

C2 - 2919139

AN - SCOPUS:0024515471

VL - 83

SP - 348

EP - 354

JO - Pediatrics

JF - Pediatrics

SN - 0031-4005

IS - 3

ER -

Charon A, Taeusch HW, Fitzgibbon C, Smith GB, Treves ST, Phelps D. Factors associated with surfactant treatment response in infants with severe respiratory distress syndrome. Pediatrics. 1989 Jan 1;83(3):348-354.