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Licensed Unlicensed Requires Authentication Published by De Gruyter June 1, 2005

Effects of surfactant treatment on gas-exchange and clinical course in near-term newborns with RDS

  • S. G. Golombek and W. E. Truog

Abstract

Objective: To determine if there is a relationship between acute improvement in pulmonary gas exchange and surfactant use in near-term (35–39 weeks' gestation) infants with respiratory distress syndrome (RDS).

Methods: We examined retrospectively the records of 54 infants admitted during a 15 month period who were 35 or more weeks of gestation, and who demonstrated all the diagnostic features of RDS. Data analyzed included: birth weight; gestational age; Apgar scores; calculated alveolar to arterial oxygen gradient (AaDO2) and oxygenation index (0I); hours of life at intubation; surfactant administration; complications with surfactant administration; use of inotropic medications.

Results: A total of 30 of infants were treated with intubation and surfactant administration. Mean FiO2 at the time of surfactant administration was 0.96. The AaDO2 decreased from 64.0 ± 14.8 kPa to 41.8 ± 22.5 kPa by 6 hrs (p < 0.0001). There was no relationship between age at treatment (6–89 hr) and response to treatment as measured by changes in AaDO2, FiO2, or oxygenation index (OI).

Conclusions: Near-term infants with severe RDS often respond to exogenous surfactant, suggesting a functional deficiency of endogenous surfactant at a “late” stage in their disease process.

We speculate that delayed treatment may still be effective in these patients.

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Published Online: 2005-06-01
Published in Print: 2000-11-20

Copyright (c)2000 by Walter de Gruyter GmbH & Co. KG

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