Ballard PL, et al. - Given that many premature infants with respiratory failure are deficient in surfactant, researchers intended to explore the relationship to the occurrence of bronchopulmonary dysplasia (BPD) in this analysis. For this investigation, they collected tracheal aspirates from 209 treated and control infants recruited at 7–14 days in the Trial of Late Surfactant. Findings revealed that many intubated premature infants were deficient in active surfactant, in part due to increased intra-alveolar metabolism, low SP-B content, and protein inhibition and that the severity of this deficit was predictive of BPD. They found that late surfactant treatment at the frequency used did not provide a sustained increase in airway surfactant. It was noted that tracheal aspirates with lower amounts of recovered surfactant had an increased proportion of small vesicle (inactive) surfactant.