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Surfactant use and efficacy can be difficult to evaluate before surgical repair due to unexpanded and/or agenesic lung involved in diaphragmatic hernia. If controlateral lung presents surfactant deficiency, supplementation can be useful to improve oxygenation.
A retrospective review, conducted by Valls i Soler on behalf of Collaborative Surfactant Study Group, on 48 infants with CDH proved that surfactant supplementation was useful to improve oxygenation if given early or prophylactically. Repeated doses were necessary in 1/4 of newborns. Survival was not connected directly with precocious surfactant supplementation but with possibility of stabilization of clinical status before surgical repair, severity of lung agenesia and 1 min Apgar score.
Valls i Soler A, Fernandez-Ruanova B, Robertson B on behalf of the collaborative Surfactant Study Group. Biol Neonate 1998