Background: Exogenous surfactant was introduced into treatment of neonatal RDS over 20 years ago.Since that time indications for surfactant were extended to ‘non-RDS ’aetiology.We present three cases of blood aspiration syndrome treated with exogenous surfactant. Material/Methods: Neonates were delivered by emergency cesarean section at Polish Mother ’s Memorial Hospital beceause of pre- mature placental ablation. Mean gestational age was 37.3 weeks,mean birth weight 2766 g (1700 –3450 g).After tracheal suction- ing under direct laryngoscopy infants were intubated and ventilatory support with high respirator settings was started.Mean initial value of Oxygenation Index (OI)was 36.3 and alveolar-to-arterial oxygen gradient (A-a DO 2 )611.7 torr.All patients were treated with natural surfactant.One infant received two boluses,the remaining two were treated with broncho-alveolar surfactant lavage (5 mg phospholipids/mL;15 mL/kg). Results: In patient who received bolus of surfactant blood clots were obtained from respiratory tract with subsequent improvement of ventilation.In neonates treated with lavage a normalization gas exchange was also noticed (after 24 hours OI dropped by 92.1%and A-a DO 2 by 92.3%).Extubation was possible in all three patients with no signs of pulmonary hemorrhage or other side effects associated with surfactant administration. Conclusions: This first data concerning natural surfactant usage in blood aspiration syndrome suggest potential benefits.

Keywords: blood aspiration syndrome, surfactant, newborn infant