Outcome of surfactant therapy in neonates with respiratory distress

Journal Title: Medpulse International Journal of Pediatrics - Year 2019, Vol 10, Issue 3

Abstract

Background:Respiratory Distress is the most common presenting complaints and remains a leading cause of neonatal morbidity and mortality worldwide. Objectives:This study was conducted to evaluate the effect andtheoutcome of exogenous surfactant therapy in neonates with respiratory distress due to RDS, Meconium aspiration syndrome and pneumonia. Materials and Methods:This prospective study was conducted in the SCABU andIntensive Care Unit (ICU) of Dhaka Shishu (Children) Hospital. Neonates presented with respiratory distress due to RDS, Meconium aspiration syndrome, PPHN and pneumonia were included in this study.All included neonates were treated with bovine origin semi-synthetic surfactant as rescue therapy. Surfactant was administered by using the standard procedure.Effects of surfactant therapy, type and duration of respiratory support, complications and outcome were assessed.Paired t-test was used to compare the effectiveness of surfactant use. Pvalue of <0.05 was considered significant.Results:Among the enrolled neonates about two-thirds (58.3%) were VLBW (<1500gm). Respiratory distress due to RDS was in 50.0% cases. All enrolled neonates were out-born and reached hospital within 8.4±2.1 hours of birth. Age of surfactant instillation was 19.5±6.8 hours and 91.7% neonates received surfactant within 24 hours of age.There was a significant (p<0.05) change in respiratory rate, SpO2, PCO2 and PO2 after six hours of surfactant administration. Respiratory support after surfactant administration required for a mean of 3.7±1.7 days and about half of them (41.6%) were managed by only nasal CPAP. Out of 12 neonates who received surfactant 25.0% developed complications and mortality rate was 25.0%.Conclusions:This study concluded that neonates with respiratory distress due to various causes improved with exogenous surfactant therapy.

Authors and Affiliations

Mahfuza Shirin, M Monir Hossain, Mohammad Abdullah Al Mamun

Keywords

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