Surfactant, a complex lipoprotein, reduces surface tension in pulmonary alveoli. Its deficiency leads to widespread atelectasis, barotrauma, inflammation, and tissue damage that cause respiratory distress syndrome (RDS) in preterm and low-birth-weight infants. Before the development of surfactant therapy, RDS affected 40% to 60% of infants with birth weight (BW) 500 to 1,500 g, with ≥20% mortality.¹ This was the first human study exploring whether treatment with artificial surfactant improved outcomes in neonates with severe RDS.

To assess the impact of artificial surfactant delivery on subsequent need for ventilation and clinical outcomes in preterm neonates.

Prospective cohort study in a single center in Japan in 1979.