Comparison of Clinical Progress between Single- and Multiple-dose Surfactant Treatment in Neonatal Respiratory Distress Syndrome

Kil, Chang Hee; Jeon, Ho Sang; Bae, Chong Woo

Abstract

PURPOSE
In the case of serious respiratory distress syndrome (RDS) or relapse of clinical appearances after single treatment, we obtained more effective results with multiple-dose surfactant replacement therapy. We carried out this investigation for comparing and observing clinical progress between single-dose (group S) and multiple-dose (group M) pulmonary surfactant treatment group of neonatal RDS. METHODS: We investigated 48 neonates who were diagnosed as RDS and treated with pulmonary surfactant (PS) replacement therapy in NICU of Kyunghee University hospital from January 2002 to March 2004, then we compared and verified clinical progress of 32 neonates in group S with that of 16 neonates in group M. RESULTS: There were no significant statistical differences in average birth weights, average gestational periods, initial pH values of birth, whether operation of resuscitation at that time of birth was made or not, whether prenatal steroid prescription for mother, RDS classification standardized by Bomsel, and ventilation index (VI) before instillation of PS of two groups. However, there was significant statistical difference in a/A PO2 (P< 0.05). We could observe changes of VI and a/A PO2 within 72 hours have been continuously improved at group S rather than group M. In spite of relapses, group M changed for the better after second dose. There were also no significant differences between the two groups in duration of ventilator therapy, mortality within 28 days after birth, intraventricular hemorrhage by complication, retinopathy of premature, necrotizing enterocolitis, chronic lung diseases, sepsis, and DIC. CONCLUSION: In these relapse cases, as there were no significant differences in the mortality rate and the occurence of complication between group S and group M, the requirement of multiple-dose PS replacement therapy which brought improvement of prognosis was emphasized.