Surfactant Replacement Therapy

I am very happy and honoured to have so many famous contrib utors from around the world presenting their knowledge and experience in this book, including Dr. Rufer who, as early as 1967, attempted to improve the pressure-volume curve of a child dying from RDS using dried surfactant from dogs; Drs. Enhorn ing and Robertson who were the first to treat rabbit fetuses with surfactant replacement and impressively demonstrated that sur factant improved lung mechanics; and Dr. Fujiwara who at the end of the 1970's had already successfully treated the first babies with surfactant replacement and published this work al ready in 1980. Thus, the idea of surfactant replacement therapy is now more or less 20 years old and almost 10 years have passed since the first publication by Dr. Fujiwara of his impressive clinical results. Up to now (September, 1988) about 2,200 babies have been treated worldwide with tracheal instillation of surfactant, with most promising results. The type of surfactant used varies from pure natural extracts from bovine or pig lungs, to surfactant extracted from human amniotic fluid, to pure phospholipids. To date, however, there is still no surfactant commercially available (except in Japan), in spite of the fact that it is urgently awaited by neonatologists and intensive care doctors throughout the world. This volume is based on the contributions presented at the international congress on Surfactant Replacement Therapy which was held in Rotterdam, The Netherlands, in November 1987.

Integrating basic and clinical research on the biophysical and physiological functions of pulmonary surfactants, this practical reference presents thorough, cutting-edge coverage on surfactant-related lung disease. Manage neonatal respiratory distress syndrome (RDS), acute respiratory distress syndrome (ARDS), and acute lung injury more effecti

Innovations and Frontiers in Neonatology provides up-to-date information for clinicians and scientists interested in perinatal medicine. Neonatal transition, neonatal medicine from a global perspective, aspects of care including nutrition, respiratory and temperature management, resuscitation, family-centered approaches, and problems of the term newborn are covered as are complications and long-term consequences of preterm birth. Should we ventilate and how? What are the lifelong consequences of being born too small? How can we protect the neonatal brain? Can we actively influence the microbiome? Can we achieve individualized medicine with the help of metabolomics, for example? Are stem cells the miracle cure? These are just a few of the questions that world experts cover in this book while, at the same time, they take a look at the future of neonatal medicine.

This companion volume to the highly acclaimed Effective Care in Pregnancy and Childbirth (OUP 1989, edited by Iain Chalmers et al.) evaluates the care of newborn infants. Medical research has produced an explosion of new knowledge concerning the causes, diagnosis, prognosis, treatment and prevention of diseases of the newborn infant. As the pace of therapeutic innovation quickens, there is an increasing need for efficient access to information concerning the probable effects of therapy. This book meets the urgent demand for a systematic summary of the best available evidence concerning the expected outcomes of therapeutic decisions in neonatology. This revolutionary work consists fundamentally of quantitative reviews of randomized trials of alternative courses of action. It contains some 2000 new analyses of data from the clinical trials literature, representing the vast majority of randomized trials in neonatology. The result is the first systematic review of evidence from randomized clinical trials in this field and an explicit dissection of the research data supporting, or in some cases not supporting, clinical management of the newborn. This book will interest pediatricians, especially neonatologists; obstetricians, especially maternal-fetal medicine specialists; family practitioners; and epidemiologists.

One of the key tools in effectively managing critical illness is the use of mechanical ventilator support. This essential text helps you navigate this rapidly evolving technology and understand the latest research and treatment modalities. A deeper understanding of the effects of mechanical ventilation will enable you to optimize patient outcomes while reducing the risk of trauma to the lungs and other organ systems. A physiologically-based approach helps you better understand the impact of mechanical ventilation on cytokine levels, lung physiology, and other organ systems. The latest guidelines and protocols help you minimize trauma to the lungs and reduce patient length of stay. Expert contributors provide the latest knowledge on all aspects of mechanical ventilation, from basic principles and invasive and non-invasive techniques to patient monitoring and controlling costs in the ICU. Comprehensive coverage of advanced biological therapies helps you master cutting-edge techniques involving surfactant therapy, nitric oxide therapy, and cytokine modulators. Detailed discussions of both neonatal and pediatric ventilator support helps you better meet the unique needs of younger patients.