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Surfactant Replacement Therapy in Premature Babies with Respiratory Distress Syndrome: Factors Affecting the Response to Surfactant and Comparison of Outcome from 1982–86 and 1987–91
Author(s) -
Konishi Mineo,
Chida Shoichi,
Shimada Senji,
Kasai Takeo,
Murakami Yoichi,
Cho Kazutoshi,
Fujii Yutaka,
Maeta Haruo,
Fujiwara Tetsuro
Publication year - 1992
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/j.1442-200x.1992.tb01021.x
Subject(s) - medicine , surfactant therapy , respiratory distress , pulmonary surfactant , gestational age , asphyxia , pediatrics , neonatal respiratory distress syndrome , lung , surgery , pregnancy , genetics , physics , biology , thermodynamics
The impact of surfactant therapy on chronic lung disease remains uncertain. During the past decade (1982–91), over 300 babies with respiratory distress syndrome (RDS) weighing 501–2,500 g at birth were consecutively treated with surfactant‐TA at our neonatal intensive care unit. Data on 95 RDS babies treated in the first 5 year period (Period 1, 1982–86) were compared with those on 158 RDS babies treated in the second 5 year period (Period 2, 1987–91). Overall respiratory improvement was better in Period 2 than in Period 1. In Period 2, surfactant therapy converted 98% of the babies with moderate/severe RDS to those with ‘near normal’ lung by 72 hr post‐treatment. In Period 2, 95% of the surfactant‐treated babies weighing 501–1,750 g at birth survived, 97% of which required no supplemental oxygen at 40 weeks corrected gestational age. Increased survival rate in the surfactant‐treated babies during the past decade has not been followed by a parallel increase in chronic lung disease. The severity of the initial pulmonary disease per se was not the significant risk factor for chronic lung disease. Several other variables affecting the response to surfactant therapy and outcome have been identified by stepwise logistic regression analysis and include factors related to perinatal events such as birth asphyxia and infection, and other complications of prematurity.