EXOGENOUS LUNG SURFACTANT (NAT) FOR THE TREATMENT OF SEVERE HYALINE MEMBRANE DISEASE (HMD) INITIAL CLINICAL EXPERIENCE

At the Anual SLAIP Meeting in 1988 we presented the method of procedure and biochemical features of a Nat obtained by bronchioalveolar lavage of bovine lungs. This product is how being elaborated by an Argentinan laboratory. Between 8-1-90 and 7-31-91, 40 premature infants (Pret) less than 37 weeks gestational age, diagnosed a HMD and in mechanical ventilation, were treated by tracheal insulation with Nat (90mg/kg) in the first hours of life. Additional doses were given up to 48 hs., based on clinical requirements. The treated group had a birth weight of =1268gr (r=630-2470) and a gestational age of =29.1 weeks (r=23-36). The first dose was administered at =4.7hs. (r=0.5-24). Before it the FiO2 was =0.81 (SD=0.2), the PaO2 =59mmhg (SD=15) and the mean airway pressure (Paw) =9.2cm H2O (SD=3.8). Ten minutes afterwards the PaO2 was =145mmHg (SD=51)(p 1000gr. Seven patients (17.5%) had air leaks (4 pneumothorax and 4 interstitial emphysema). Three Pret developed bronchopulmonary dysplasia. Nat may be helpful in the treatment of the HMD in Pret.