During the past decade, significant advances in the treatment of neonatal respiratory distress syndrome (RDS) have been directly attributable to the emergence of surfactant replacement therapy. Using a variety of surfactant preparations, clinical trials have been accomplished in a number of centers on large numbers of infants. These clinical trials showed that there were applications of surfactant replacement both in the prevention mode, early in life, and in the rescue mode, once RDS is diagnosed. There were no evident adverse effects on the infants, and there was significant reduction in mortality and severity of disease in the treated infants. Currently, a large number of neonatal intensive care units are enrolling infants in treatment investigational drug (IND) protocols as defined by the Food and Drug Administration (FDA) while the new drug applications are pending. Surfactant replacement therapy has numerous implications for neonatal nurses and will be part of all neonatal nursing skills in the near future

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