Schulich School of Medicine & Dentistry

A life-saving treatment pioneered by Fred Possmayer has helped generations of at-risk premature babies survive their first days of life. Now, he’s being recognized among Canada’s medical leaders. When the biochemist began his research at Western University in the 1970s, more than half of premature babies who developed respiratory distress syndrome (RDS) died from the condition. Today, the surfactant treatment Possmayer helped develop has been used to treat more than 160,000 premature babies in Canada and around the world. https://www.youtube.com/watch?v=7O_HnHteNLA For his contributions to neonatal medicine, the professor emeritus at Western’s Schulich School of Medicine & Dentistry is among the Canadian Medical Hall of Fame’s 2027 inductees. It is an unexpected honour for Possmayer. “I didn’t do anything spectacular,” he reflected. “It was serendipity – a well-prepared mind and being in the right place, at the right time, with the right people.”  

Transforming the odds of survival

At the heart of RDS is a lack of sufficient pulmonary surfactant, a substance that helps keep the tiny air sacs in the lungs open. Without enough surfactant, the lungs become stiff and can collapse with each breath, making it extremely difficult for newborns to breathe. American paediatrician Dr. Mary Ellen Avery first identified the cause of RDS in 1957. Possmayer, whose research had focused on phospholipid metabolism in the liver and brain, joined a select group of scientists around the world in the search for a treatment. Collaborations with Dr. Goran Enhorning at the University of Toronto led him to develop a methods for isolating and preparing surfactant extracts from bovine lungs which could be used in premature infants. The resulting treatment, known as bovine lipid extract surfactant (BLES), was tested in clinical trials, with Canadian findings published in 1983. It was subsequently made available in Canadian hospitals before receiving formal drug approval in the late 1990s. BLES is now used across Canada and in more than 20 other countries, and surfactant replacement therapy has become a cornerstone of modern neonatal intensive care.  

A legacy of discovery

Throughout his career, Possmayer has emphasized the collective nature of scientific progress, crediting the researchers and clinicians whose work helped make surfactant therapy possible. He also remains a champion of scientific curiosity, persistence and the willingness to challenge assumptions. “You need to have a strong desire to understand, to obtain data to show your ideas are correct. Or better yet, that they are wrong, because that can generate new directions and real progress,” he said in an interview for The Impact Project. His contributions have earned numerous honours, including the Order of Ontario in 2024. BLES has also been recognized by the Council of Ontario Universities as one of the province’s top five medical breakthroughs. “I have to be pleased and even proud that our work has benefitted many babies and their families,” he said. Learn more about how Western is optimizing health for all.