Author/Editor		Babnik, Janez; Kornhauser-Cerar, Lilijana; Pestevšek, Maja; Tonin, Tatjana
Title		Surfactant replacement theapy for severe neonatal respiratory distress syndrome: higher incidence of intracranial haemorrhage - consequence or coincidence?
Translated title		Zdravljenje hude dihalne stiske novorojenčka s sulfraktantom: več možganskih krvavitev - posledica ali slučajnost?
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 65, št. 1
Publication year		1996
Volume		str. 1-4
Language		eng
Abstract		Backround. Evaluation of the results of exogenous surfactant replacement therapy for neonatal respiratory distress syndrome and comparison with outcomes of previous treatment. Patients and methods. The group of treated neonates was enrolled in the international,Curosurf 4 trial. The inclusion criteria were the following: 1. respiratory distress detected clinically and with X-rays; 2. tracheal intubation and mechanical ventilation; 3. age: control group of neonates, born within 20 months before the study started, was selected using computer data, strictly following the same inclusion criteria as for the study group. Results. 33 neonates who underwent the surfactant, replacement therapy were compared to 36 neonates of the control group. After the first dose of surfactant the a/A oxygen ratio increased from 0.11 to 0.20 and FiO2 could be lowered from 0.80 to 0.60. Survival did not significantly differ between the groups (73% vs 69 %). Neonates treated with surfactant often had open ductus arteriosus (52% vs 25%), higher incidence of intracranial haemorrhage (61% vs 42%), however, on average they needed 5 days less of artificial ventilation and shorter treatment with oxygen. A higher incidence of intracranial haemorrhage in the study group is the result of coincidental selection of newborns with lowest gestational age (26.1 wks) and at the same time with the severest form of respiratory distress (a/A O2<0.07). Conclusions. The immediate effect of surfactant replacement therapy is the improvement of ventilation (increase of a/A O2 and decrease of the necessary FiO2). The final effect of treatment is shorter ventilation and shorter requirement for oxygen. A higher incidence of intracranial haemorrhage after the surfactant application results from a higher number of preterm infants with the severest form of respiratory distress syndrome in the study group.
Descriptors		PULMONARY SURFACTANTS RESPIRATORY DISTRESS SYNDROME CEREBRAL HEMORRHAGE INFANT, NEWBORN RESPIRATION, ARTIFICIAL INFANT, PREMATURE GESTATIONAL AGE BIRTH WEIGHT TREATMENT OUTCOME