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[Surfactant treatment of newborn infants receiving continuous positive airway pressure treatment].

AbstractINTRODUCTION:
The purpose of this study was to examine the efficiency of a single dose of fast-acting exogenous surfactant (Curosurf) given to premature babies with progressive respiratory insufficiency. Curosurf was given as early rescue therapy during a brief intubation (INSURE method: INtubation-SURfactant-Extubation) during treatment with nasal Continuous Positive Airway Pressure (CPAP).
MATERIALS AND METHODS:
Retrospective study of 115 premature infants with respiratory distress syndrome born and treated at Odense University Hospital during the years 1999 to 2004. The criterion for surfactant treatment was a decrease in the arterial/alveolar oxygen tension ratio (or corresponding values for the fraction of inspired oxygen) below 0.36 in infants with gestational age (GA) < 30 weeks and 0.22 in more mature infants.
RESULTS:
The primary end point was survival during the first week of life without mechanical ventilation. This end point was reached by 51% of the infants with GA < 30 weeks. However, the effect proved to be GA-dependent, increasing from 22% in infants with a GA of 24-25 weeks to 86% in week 29. Seventy percent survived to be discharged. In infants with GA > 29 weeks the effect was 87%, and all survived.
CONCLUSION:
The effect of surfactant therapy administered per the INSURE method is GA-dependent, and the method works best after GA week 25. The question is whether earlier therapy will increase its efficiency or the method has reached its limit.
AuthorsTina Andersen, Hanne Spangsberg Holm, Jens Kamper
JournalUgeskrift for laeger (Ugeskr Laeger) Vol. 168 Issue 43 Pg. 3723-7 (Oct 23 2006) ISSN: 1603-6824 [Electronic] Denmark
Vernacular TitleSurfaktantbehandling af nyfødte børn i continuous positive airway pressure-behandling.
PMID17069738 (Publication Type: English Abstract, Journal Article)
Chemical References
  • Biological Products
  • Phospholipids
  • Pulmonary Surfactants
  • poractant alfa
Topics
  • Biological Products (administration & dosage)
  • Continuous Positive Airway Pressure
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Phospholipids (administration & dosage)
  • Pulmonary Surfactants (administration & dosage)
  • Respiratory Distress Syndrome, Newborn (drug therapy, therapy)
  • Retrospective Studies
  • Treatment Outcome

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