Title | The role of exogenous surfactant in the treatment of preterm neonates with chronic lung disease | |
Authors | Christos Tsakalidis, Paraskevi Karagianni, Dimitris Rallis, Evangelia Giougki, Anastasia Kalesi, Charalampos Dokos and Nikolaos Nikolaidis
2nd Neonatal Intensive Care Unit, General Hospital Papageorgiou, Aristotle University, Thessaloniki, Hellas |
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Citation | Tsakalidis, C., Karagianni, P., Rallis, D., Giougki, E., Kalesi, A. et al.: The role of exogenous surfactant in the treatment of preterm neonates with chronic lung disease, Epitheorese Klin. Farmakol. Farmakokinet. 24(3): 247-253 (2010) | |
Publication Date | Accepted for publication (Final Version): April 10, 2010 | |
Full Text Language | English | |
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Keywords | Oxygenation index, alveolar-arterial oxygen difference, arterial-alveolar oxygen ratio, surfactant, chronic lung disease. | |
Other Terms | review article | |
Summary | The aim of this study was to investigate the effect of surfactant (SF) administration in the treatment of respiratory insufficiency in neonates with Chronic Lung Disease (CLD). 32 premature neonates with birth weight (BW) <1500gr, who at the age of 8-30 days needed mechanical ventilation with FiO2 at least 0.4 along with radiological findings compatible with CLD, were prospectively studied. The neonates were randomly classified into two treatment groups: the SFgroup (n=15) that was treated with SF (2 doses of 100mg/Kg of natural bovine surfactant Survanta®) and the control group (n=17). The course of oxygenation index (OI), alveolar-arterial oxygen difference (A-aDO2) and the arterial-alveolar oxygen ratio (Pa/AO2), the duration of mechanical ventilation, oxygen administration, hospitalization and survival were evaluated. The two groups were comparable regarding the epidemiological and clinical characteristics nor did they differ significantly with respect to the frequency of neonatal problems, which affect the appearance of CLD, such as the severity of respiratory distress syndrome (RDS), the frequency of administration and the number of doses of SF for the treatment of RDS, the frequency of patent ductus arteriosis (PDA), the pneumothorax and the sepsis. Surfactant administration not only did it not have any direct good result on the oxygenation estimation indexes but was followed by a transient deterioration of oxygenation and an increase of the need for mechanical ventilation, which returned to the pre-treatment levels in about 6 hours. As far as the remaining indexes survival was high in both groups, while the duration of hospitalization and oxygenation administration was similar. However, the duration of mechanical ventilation was significantly less in the surfactant treated group. Surfactant administration to neonates with CLD contributes to the faster weaning of the neonate from the ventilation, although no immediate improvement in the oxygenation is observed. | |
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