In November 1990, neonatology will complete its 25th year as a recognized specialty of pediatrics. The focus for neonatal intensive care continues to be on development of techniques to improve outcome for the high-risk newborn. Major effort has gone into evaluation of methods for treating the respiratory distress syndrome, which remains one of the leading causes of mortality and morbidity. At the same time, the neonatal intensive care unit is not isolated from important events that occur in society. The way in which some of these changes affect the current management and long-term outcome for the newborn infant will be described in this article.
Surfactant for treatment of the respiratory distress syndrome has been in clinical trial in both Europe and the United States.1,2 In contrast to the hopes for a major breakthrough, the results have been somewhat disappointing. Immediate improvement in pulmonary function and a decrease in the