Surfactant use outside the tertiary care centre.

Early administration of surfactant to preterm babies with respiratory distress syndrome saves lives and decreases morbidity such as pneumothorax. Surfactant administration shortly after birth to intubated babies less than 30 weeks gestation decreases pulmonary air leak, chronic lung disease and mortality. Some preterm babies may be born in hospitals with a transport team hours away. Surfactant administration may cause transient bradycardia or hypoxemia and may rapidly improve lung function. As preterm babies born outside of tertiary care centres will benefit from early administration of surfactant, every peripheral hospital performing deliveries should develop a plan in association with physicians in referral hospitals to provide this potentially life saving therapy.