Surfactant Therapy for Respiratory Distress Syndrome in High- and Ultra-High-Altitude Settings.

Abstract

Objective:

The objective of this study is to investigate the therapeutic effect of surfactant replacement therapy (SRT) on respiratory distress syndrome (RDS) in premature infants in the Qinghai-Tibet Plateau.

Materials and Methods:

This multi-center retrospective cohort study collected and screened reasonable clinical data of 337 premature infants with RDS from 10 hospitals in the Qinghai-Tibet Plateau from 2015 to 2017. We grouped the cases by rationally analyzing their baseline characteristics, using logistic analysis to evaluate each factor's effect on the prognosis of the infants, and comparing the short-term improvement in blood gas and mortality after SRT treatment at different altitudes, in high-altitude (1,500-3,500 m) and ultra-high-altitude (3,500-5,500 m) groups.

Results:

Independent of altitude, the mortality rate of children with RDS in the SRT group was significantly lower than that of children in the non-SRT group (both P < 0.05). The effect of SRT on preterm infants with RDS in the high-altitude group [odds ratio (OR) = 0.44, 95% confidence interval (CI) = 0.22-0.87, P = 0.02] was better than that in the infants in the ultra-high-altitude group (OR = 0.26, 95% CI = 0.13-0.58, P < 0.01), with death rates of 34.34 and 49.71%, respectively. Similarly, after SRT, the improvement of PaO2/FiO2 and pH of children at high altitude was significantly better than those of children at ultra-high altitude (all P < 0.01).

Conclusions:

SRT plays a prominent role in curing infants with RDS in both high- and ultra-high-altitude regions, although with better effects at high rather than ultra-high altitude. This study provides a basis for further large-scale studies on SRT for RDS treatment at high altitudes.

• Authors: Xudong Duan, Jiujun Li, Long Chen, Yuan Shi, Xianyang Chen, Teng Xue, Chongde Liu, Xiaorong Wang, Quanfang Qiu, Zhen Yu, Bacuozhen Qiang, Hong Wu, Tianqi Wu, Lihong Zhang, Zhangsheng Chen, Dobje Jigme, Aili Xu, Zhuoga Mima, Zhen Da, Min Ren, Deji Gesang, Zhaxi Pubu, Chun Li, Yanchao Lv, Haoquan Zhou, Xue Zhang, Zhuoma Dawa, Wujin Gongjue, Li Wang, Li Wu, Xuelian Li
• Journal: Frontiers in pediatrics (Front Pediatr) Vol. 10 Pg. 777360 ( 2022) ISSN: 2296-2360 [Print] Switzerland
• PMID: 35311054 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 Duan, Li, Chen, Shi, Chen, Xue, Liu, Wang, Qiu, Yu, Qiang, Wu, Wu, Zhang, Chen, Jigme, Xu, Mima, Da, Ren, Gesang, Pubu, Li, Lv, Zhou, Zhang, Dawa, Gongjue, Wang, Wu and Li.