It is now clearly established that respiratory distress syndrome (RDS) is associated with prematurity-related surfactant deficiency. Since its discovery,[1] there has been a considerable amount of research defining the biochemical composition of surfactant and its relationship to pulmonary function. A considerable amount of research has also been performed on animals to formulate the scientific basis for surfactant replacement therapy in premature infants to prevent or reduce the severity of RDS.

Clinical trials began with the rescue therapy by Fujiwara et al[2] and were followed by several single institution or multi-center trials using bovine, human, or synthetic surfactants.

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