Original scientific paper

Surfactant administration in premature infants with RDS

Ismeta Kalkan ; Neonatal Intensive Care Unit, Pediatric Hospital, Clinical Centre Sarajevo, Bolnička 25, 71000 Sarajevo, Bosnia and Herzegovina
Suada Heljic ; Neonatal Intensive Care Unit, Pediatric Hospital, Clinical Centre Sarajevo, Bolnička 25, 71000 Sarajevo, Bosnia and Herzegovina
Amra Cengic ; Neonatal Intensive Care Unit, Pediatric Hospital, Clinical Centre Sarajevo, Bolnička 25, 71000 Sarajevo, Bosnia and Herzegovina
Verica Misanovic ; Neonatal Intensive Care Unit, Pediatric Hospital, Clinical Centre Sarajevo, Bolnička 25, 71000 Sarajevo, Bosnia and Herzegovina
Dusko Anic ; Neonatal Intensive Care Unit, Pediatric Hospital, Clinical Centre Sarajevo, Bolnička 25, 71000 Sarajevo, Bosnia and Herzegovina
Fedzat Jonuzi ; Neonatal Intensive Care Unit, Pediatric Hospital, Clinical Centre Sarajevo, Bolnička 25, 71000 Sarajevo, Bosnia and Herzegovina
Hajrija Maksic ; Neonatal Intensive Care Unit, Pediatric Hospital, Clinical Centre Sarajevo, Bolnička 25, 71000 Sarajevo, Bosnia and Herzegovina

Abstract

Background. The significant advancement in the treatment of respiratory distress syndrome can be attributed to prenatal identification of high risk pregnancies, prevention of illness through antenatal care, prenatal administration of glucocorticoids, advancement in respiratory support and surfactant therapy. These measures resulted in the reduction of mortality and morbidity rates in preterm infants.
Patients and methods. We analyzed data of 78 preterm babies with respiratory distress syndrome hospitalized in the NICU of the Pediatric Clinic, KCU Sarajevo. All children included in the study were mechanically ventilated and treated with one or more doses of bovine surfactant (Survanta) as rescue therapy. Surfactant was given to children with clinical and radiological signs of RDS, who required FiO2>0,40. We used the standard procedure of giving surfactant therapy to intubated children in sterile conditions, after we confirmed, by X-ray, correct tube placement.
Results. We investigated the clinical efficacy of surfactant in relation to time of administration, O2 requirement and necessity of one or more doses of surfactant. We found that early treatment with surfactant replacement- within 6 hours of birth- is more effective, and resulted in a significant reduction of mortality rate (p<0,01). Treatment with multiple doses is more effective in comparison to one dose, although there was not a significant difference (p<0,20) between the treated groups. There is a significant difference (p<0,01) between groups related to O2 requirement. In the group of babies which required 60% or more O2 concentration in inhaled air at the time of surfactant replacement, mortality rate was significantly higher (p<0,01).
Conclusion. Our study confirmed the benefits of surfactant therapy in preterm babies with respiratory distress syndrome. We confirmed the advantages of early treatment vs. late treatment, but we could not confirm the obvious advantage of multiple over single doses. So, a reasonable recommendation is to treat the infants as soon as clinical signs of developing respiratory distress appear with an individual dose for each infant.

Keywords

respiratory distress syndrome; surfactant; preterm

Hrčak ID:

11966

URI

https://hrcak.srce.hr/11966

Publication date:

1.4.2007.

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