Related Experiment Video

Updated: May 21, 2026

Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome (ARDS)
06:22

Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome (ARDS)

Published on: April 7, 2021

Surfactant retreatment in very preterm infants with respiratory distress syndrome: an observational cohort study

Carlo Dani1,2, Marina Lo Nigro1, Chiara Poggi2

  • 1Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy.

Translational Pediatrics
|May 20, 2026
PubMed

Insights

Surfactant retreatment effectively improved oxygenation in very preterm infants with respiratory distress syndrome. Lower initial oxygenation levels may predict the need for additional surfactant doses.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Critical Care

Background:

  • Limited data exists on surfactant retreatment for respiratory distress syndrome (RDS) in preterm infants.
  • International guidelines lack specific recommendations for surfactant retreatment.
  • This study addresses the effectiveness of surfactant retreatment in very preterm infants (VPI).

Purpose of the Study:

  • To evaluate the effectiveness of surfactant retreatment in very preterm infants (VPI) with RDS.
  • To determine if initial oxygenation parameters can predict the need for multiple surfactant doses.

Main Methods:

  • Retrospective study of 140 VPI (23+0-29+6 weeks gestation) requiring surfactant treatment.
  • Analysis of peripheral oxygen saturation/fraction of inspired oxygen (SpO2/FiO2) and arterial/alveolar partial pressure of oxygen (a/APO2) ratios before and after surfactant doses.
  • Comparison of infants receiving single vs. multiple surfactant doses.

Main Results:

  • 39% of infants received one surfactant dose, while 61% required multiple doses.
  • Both first and second surfactant doses significantly improved SpO2/FiO2 and a/APO2 ratios.
  • Pre-first dose SpO2/FiO2 ratio was inversely correlated with the need for a second dose (OR 0.994, P=0.047).

Conclusions:

  • Surfactant retreatment is effective in improving oxygenation in VPI with RDS.
  • Low initial SpO2/FiO2 ratios may identify infants needing multiple surfactant doses.
  • Further research is needed to standardize multiple-dose surfactant treatment protocols.
Abstract

Keywords:
Surfactantpreterm infantrespiratory distress syndrome (RDS)retreatment

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