S. G. Golombek, W. E. Truog
Effects of surfactant treatment on gas-exchange and clinical course in near-term newborns with RDS
Objective: To determine if there is a relationship
between acute improvement in pulmonary gas exchange
and surfactant use in near-term (35–39 weeks' gestation)
infants with respiratory distress syndrome (RDS).
Methods: We examined retrospectively the records of
54 infants admitted during a 15 month period who were
35 or more weeks of gestation, and who demonstrated
all the diagnostic features of RDS. Data analyzed included:
birth weight; gestational age; Apgar scores; calculated
alveolar to arterial oxygen gradient (AaDO2)
and oxygenation index (0I); hours of life at intubation;
surfactant administration; complications with surfactant
administration; use of inotropic medications.
Results: A total of 30 of infants were treated with intubation
and surfactant administration. Mean FiO2 at the
time of surfactant administration was 0.96. The AaDO2
decreased from 64.0 ± 14.8 kPa to 41.8 ± 22.5 kPa by
6 hrs (p < 0.0001). There was no relationship between
age at treatment (6–89 hr) and response to treatment
as measured by changes in AaDO2, FiO2, or oxygenation
index (OI).
Conclusions: Near-term infants with severe RDS often
respond to exogenous surfactant, suggesting a functional
deficiency of endogenous surfactant at a “late”
stage in their disease process.
We speculate that delayed treatment may still be effective
in these patients.
Journal of Perinatal Medicine, Walter de Gruyter
Print ISSN: 1619-3997
Volume: 28, 11/2000
Pages: 436 - 442
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