The Role of Surfactant Therapy in Nonrespiratory Distress Syndrome Conditions in Neonates

Abstract

While treatment of respiratory distress syndrome (RDS) with surfactant in premature neonates is well established, evidence for its use in non-RDS conditions, especially in the term neonate, has been less abundant. The last published review on a PubMed search was in 2001. In this review, we comprehensively and critically evaluated the evidence from the literature regarding the use of surfactant in specific non-RDS disorders in neonates. Surfactant administered as a bolus should be considered in the treatment of meconium aspiration syndrome with progressive respiratory failure. While controversial in congenital diaphragmatic hernia, it should be considered in Group B streptococcal pneumonia. As evidence evolves, we anticipate the broader application and more routine use of surfactant therapy for respiratory failure because of causes other than RDS.

Keywords

non-RDS - neonate - surfactant - lung injury - meconium aspiration syndrome - pulmonary hemorrhage - congenital diaphragmatic hernia - pneumonia - aspiration

• References

• 1 Hamvas A. Pathophysiology and Management of Respiratory Distress Syndrome. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's neonatal-perinatal medicine: diseases of the fetus and infant. Vol 2. 9th ed. Philadelphia, PA: Saunders/Elsevier; 2011: 1106-1115
• 2 Soll R, Ozek E. Multiple versus single doses of exogenous surfactant for the prevention or treatment of neonatal respiratory distress syndrome. Cochrane Database Syst Rev 2009; (1) CD000141
• 3 Polin RA, Carlo WA ; Committee on Fetus and Newborn; American Academy of Pediatrics. Surfactant replacement therapy for preterm and term neonates with respiratory distress. Pediatrics 2014; 133 (1) 156-163
• 4 Holm BA, Keicher L, Liu MY, Sokolowski J, Enhorning G. Inhibition of pulmonary surfactant function by phospholipases. J Appl Physiol (1985) 1991; 71 (1) 317-321
• 5 Wang Z, Notter RH. Additivity of protein and nonprotein inhibitors of lung surfactant activity. Am J Respir Crit Care Med 1998; 158 (1) 28-35
• 6 Lin WH, Turcotte JG, Parkinson D, Thrall RS. Restoration of lung compliance with calf lung surfactant extract and a surfactant analog in an in situ model of surfactant deficiency in rats. Respiration 1996; 63 (3) 144-149
• 7 Dizon-Co L, Ikegami M, Ueda T , et al. In vivo function of surfactants containing phosphatidylcholine analogs. Am J Respir Crit Care Med 1994; 150 (4) 918-923
• 8 Lopez E, Gascoin G, Flamant C, Merhi M, Tourneux P, Baud O ; French Young Neonatologist Club. Exogenous surfactant therapy in 2013: what is next? Who, when and how should we treat newborn infants in the future?. BMC Pediatr 2013; 13: 165
• 9 Swarnam K, Soraisham AS, Sivanandan S. Advances in the management of meconium aspiration syndrome. Int J Pediatr 2012; 2012: 359571
• 10 Mokra D, Calkovska A. How to overcome surfactant dysfunction in meconium aspiration syndrome?. Respir Physiol Neurobiol 2013; 187 (1) 58-63
• 11 El Shahed AI, Dargaville P, Ohlsson A, Soll RF. Surfactant for meconium aspiration syndrome in full term/near term infants. Cochrane Database Syst Rev 2007; (3) CD002054
• 12 Hamvas A, Rodriguez R, Martin RJ, Fanaroff AA. Acquired Neonatal Pulmonary Diseases. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's neonatal-perinatal medicine: diseases of the fetus and infant. Vol 2. 9th ed. Philadelphia: Saunders/Elsevier; 2011: 1157-1166
• 13 Hahn S, Choi HJ, Soll R, Dargaville PA. Lung lavage for meconium aspiration syndrome in newborn infants. Cochrane Database Syst Rev 2013; 4: CD003486
• 14 Asabe K, Tsuji K, Handa N, Kurosaka N, Kajiwara M. Immunohistochemical distribution of surfactant apoprotein-A in congenital diaphragmatic hernia. J Pediatr Surg 1997; 32 (5) 667-672
• 15 Shehata SM, Tibboel D, Sharma HS, Mooi WJ. Impaired structural remodelling of pulmonary arteries in newborns with congenital diaphragmatic hernia: a histological study of 29 cases. J Pathol 1999; 189 (1) 112-118
• 16 Moya FR, Lally KP, Moyer VA, Blakely ML. Surfactant for newborn infants with congenital diaphragmatic hernia (Protocol). Cochrane Database Syst Rev 2003; (2). DOI: 10.1002/14651858.CD004209
• 17 Li J, Hu T, Liu W, Xiang B, Jiang X. Effect of epidermal growth factor on pulmonary hypoplasia in experimental diaphragmatic hernia. J Pediatr Surg 2004; 39 (1) 37-42
• 18 Colby CE, Lally KP, Hintz SR , et al; Congenital Diaphragmatic Hernia Study Group. Surfactant replacement therapy on ECMO does not improve outcome in neonates with congenital diaphragmatic hernia. J Pediatr Surg 2004; 39 (11) 1632-1637
• 19 Lally KP, Lally PA, Langham MR , et al; Congenital Diaphragmatic Hernia Study Group. Surfactant does not improve survival rate in preterm infants with congenital diaphragmatic hernia. J Pediatr Surg 2004; 39 (6) 829-833
• 20 Welzing L, Bagci S, Abramian A, Bartmann P, Berg C, Mueller A. CPAP combined with inhaled nitric oxide for treatment of lung hypoplasia and persistent foetal circulation due to prolonged PPROM. Early Hum Dev 2011; 87 (1) 17-20
• 21 Uga N, Ishii T, Kawase Y, Arai H, Tada H. Nitric oxide inhalation therapy in very low-birthweight infants with hypoplastic lung due to oligohydramnios. Pediatr Int 2004; 46 (1) 10-14
• 22 Kilbride HW, Thibeault DW. Neonatal complications of preterm premature rupture of membranes. Pathophysiology and management. Clin Perinatol 2001; 28 (4) 761-785
• 23 Kanavaki I, Vutskits L, Rimensberger PC. Use of therapeutic surfactant lavage in a preterm infant with massive pulmonary hemorrhage. Clin Pract 2012; 2 (3) e74
• 24 Pandit PB, Dunn MS, Colucci EA. Surfactant therapy in neonates with respiratory deterioration due to pulmonary hemorrhage. Pediatrics 1995; 95 (1) 32-36
• 25 Aziz A, Ohlsson A. Surfactant for pulmonary haemorrhage in neonates. Cochrane Database Syst Rev 2012; 7: CD005254
• 26 Bhandari V, Gagnon C, Rosenkrantz T, Hussain N. Pulmonary hemorrhage in neonates of early and late gestation. J Perinat Med 1999; 27 (5) 369-375
• 27 Amizuka T, Shimizu H, Niida Y, Ogawa Y. Surfactant therapy in neonates with respiratory failure due to haemorrhagic pulmonary oedema. Eur J Pediatr 2003; 162 (10) 697-702
• 28 Herting E, Gefeller O, Land M, van Sonderen L, Harms K, Robertson B ; Members of the Collaborative European Multicenter Study Group. Surfactant treatment of neonates with respiratory failure and group B streptococcal infection. Pediatrics 2000; 106 (5) 957-964 , discussion 1135
• 29 Herting E, Möller O, Schiffmann JH, Robertson B. Surfactant improves oxygenation in infants and children with pneumonia and acute respiratory distress syndrome. Acta Paediatr 2002; 91 (11) 1174-1178
• 30 Tan K, Lai NM, Sharma A. Surfactant for bacterial pneumonia in late preterm and term infants. Cochrane Database Syst Rev 2012; 2: CD008155
• 31 Harms K, Herting E. Successful surfactant replacement therapy in two infants with ARDS due to chlamydial pneumonia. Respiration 1994; 61 (6) 348-352
• 32 Vos GD, Rijtema MN, Blanco CE. Treatment of respiratory failure due to respiratory syncytial virus pneumonia with natural surfactant. Pediatr Pulmonol 1996; 22 (6) 412-415
• 33 Amiel-Tison C, Henrion R. Neonatal respiratory distress caused by inhalation of amniotic fluid [in French]. J Gynecol Obstet Biol Reprod (Paris) 1972; 1 (5) (Suppl. 02) 454-455
• 34 Ohlsson A, Cumming WA, Najjar H. Neonatal aspiration syndrome due to vernix caseosa. Pediatr Radiol 1985; 15 (3) 193-195
• 35 Gordon E, South M, McDougall PN, Dargaville PA. Blood aspiration syndrome as a cause of respiratory distress in the newborn infant. J Pediatr 2003; 142 (2) 200-202
• 36 Celik IH, Demirel G, Canpolat FE, Erdeve O, Dilmen U. Surfactant therapy for maternal blood aspiration: an unusual cause of neonatal respiratory distress syndrome. Indian J Pediatr 2012; 79 (10) 1358-1359
• 37 Natale F, Calzolari F, Castronovo A, Guadalupi L, De Curtis M. Surfactant replacement after acute massive milk aspiration in a very low birthweight infant. Arch Dis Child Fetal Neonatal Ed 2009; 94 (4) F312
• 38 Zecca E, Costa S, Lauriola V, Vento G, Papacci P, Romagnoli C. Bile acid pneumonia: a “new” form of neonatal respiratory distress syndrome?. Pediatrics 2004; 114 (1) 269-272
• 39 Herraez E, Lozano E, Poli E , et al. Role of macrophages in bile acid-induced inflammatory response of fetal lung during maternal cholestasis. J Mol Med (Berl) 2014; 92 (4) 359-372
• 40 De Luca D, Minucci A, Zecca E , et al. Bile acids cause secretory phospholipase A2 activity enhancement, revertible by exogenous surfactant administration. Intensive Care Med 2009; 35 (2) 321-326
• 41 Cai J, Su Z, Zhou Y , et al. Beneficial effect of exogenous surfactant in infants suffering acute respiratory distress syndrome after cardiac surgery. Eur J Cardiothorac Surg 2011; 40 (3) 557-562
• 42 Hong XY, Kong XY, Zhou GX, Liu YH, Yang XY, Feng ZC. Effects of pulmonary surfactant in treatment of acute lung injury after cardiac surgery in infants [in Chinese]. Zhonghua Er Ke Za Zhi 2012; 50 (3) 193-196
• 43 Alten JA, Borasino S, Pearce FB, Dabal RJ, Kirklin JK. Surfactant treatment for congenital heart disease patients with acute respiratory distress syndrome. Congenit Heart Dis 2010; 5 (6) 624-628
• 44 Xing Q, Zhang S, Chen Z. Protective effect of exogenous pulmonary surfactant on pulmonary function during cardiopulmonary bypass in children. Zhonghua Yi Xue Za Zhi (Taipei) 1999; 79: 112-114
• 45 Paul DA, Greenspan JS, Davis DA, Russo P, Antunes MJ. The role of cardiopulmonary bypass and surfactant in pulmonary decompensation after surgery for congenital heart disease. J Thorac Cardiovasc Surg 1999; 117 (5) 1025-1026
• 46 Griese M, Wilnhammer C, Jansen S, Rinker C. Cardiopulmonary bypass reduces pulmonary surfactant activity in infants. J Thorac Cardiovasc Surg 1999; 118 (2) 237-244
• 47 Agostoni P, Banfi C, Brioschi M , et al. Surfactant protein B and RAGE increases in the plasma during cardiopulmonary bypass: a pilot study. Eur Respir J 2011; 37 (4) 841-847
• 48 Lobacheva GV, Khar'kin AV, Aksenov AV, Kvasnikov BB, Manerova AF, Bokeriia LA. Use of the exogenous surfactant curosurf in combined therapy for acute respiratory failure in children after cardiosurgical interventions [in Russian]. Anesteziol Reanimatol 2005; (3) 35-38