Mature
lungs produce
surfactant naturally. Its function is to prevent the collapse of the tiny air sacks called
alveoli by reducing the
surface tension of the fluid within the lungs where
oxygen and
carbon dioxide are exchanged at a cellular level.
When a
premature baby is born they may not be mature enough to produce surfactant yet. Production begins in the early weeks of gestation but may not be adequate for independent breathing until the 35th week of
gestation.
Infants without adequate surfactant may develop
Respiratory Distress Syndrome (RDS) which may later develop into
Bronchopulmonary Dysplasia (BPD).
Treatment is available.
Oxygen,
respirators and other medical treatments have long been the mainstay of treatment for the premature infant’s RDS. More recently
artificial surfactant has become available and has made tremendous positive differences in many premature infant outcomes.
In 1963 the third child of Jackie and
President Kennedy died from
prematurity that was not really extreme in today’s terms. His
gestational age was about 32/33 weeks. RDS and a lack of
surfactant probably played a large part in his death. Today, the earliest age of viability of premature infants is approaching 23 weeks gestation. Granted this is the extreme end and there are many ethical as well as medical questions about these micro premies. More pertinent here, prematures of
Patrick Bouvier Kennedy’s
gestational age would rarely die today, in part because of
artificial surfactant.
interesting reading on the wider subject of ethics in the treatment of premature infants:
http://www.mnmed.org/Protected/99MNMED/9912/Lussky.html
“A Century of Neonatal Medicine”