PMID: 8950721Jan 1, 1996Paper

Controversies: synthetic or natural surfactant. The case for natural surfactant

Journal of Perinatal Medicine
H L Halliday

Abstract

Surfactant replacement therapy for respiratory distress syndrome (RDS) is not new, the first trials having been performed over 30 years ago. These early trials used synthetic protein-free surfactants administered as aerosols and were unsuccessful. Since 1980 a variety of natural and synthetic surfactant preparations have been used to treat or prevent RDS, and both demonstrate clinical effects. I have used evidence derived from 3 areas to demonstrate the superiority of natural surfactants: in vitro physical properties, in vivo physiological effects and the results of comparative clinical trials. using the pulsating bubble surfactometer, the surface tension at maximum and minimum bubble size are significantly lower for natural compared to synthetic surfactants (31 and 0 mN/m versus 53 and 29 mN/m respectively). Physiological effects of surfactants have been compared in immature rabbits and lambs and both models demonstrate the superiority of natural surfactants. For example in immature rabbits lung compliance values after 60 minutes of ventilation are 0.60 ml/cmH2O in natural surfactant treated animals, 0.44 ml/cmH2O in synthetic surfactant treated animals and 0.34 ml/cmH2O in controls (p < 0.01). The technique of meta-analysis w...Continue Reading

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Citations

Mar 1, 1997·Acta Paediatrica·H L Halliday
Feb 5, 2000·Journal of Applied Physiology·S N Ghadiali, D P Gaver
Jan 9, 2003·Annual Review of Physiology·James F Lewis, Ruud Veldhuizen
Feb 26, 1998·American Journal of Respiratory and Critical Care Medicine·A J DavisM Ikegami
Mar 26, 2005·Journal of Applied Physiology·Shannon L SeurynckMark Johnson
Jan 8, 2004·Experimental Biology and Medicine·Mark E BostonDavid G Oelberg
Dec 24, 2005·Expert Opinion on Investigational Drugs·Adam Maruscak, Jim F Lewis
Oct 13, 2000·Biochimica Et Biophysica Acta·E J Veldhuizen, H P Haagsman
Oct 7, 2008·Accounts of Chemical Research·Nathan J BrownAnnelise E Barron

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