Radiographic findings associated with surfactant treatment.
Radiographs of the chest (CXR) were evaluated in 35 of 41 infants enrolled in a randomized controlled trial of modified bovine surfactant extract (Surfactant-TA Tokyo-Tanabe) treatment. Infants between birthweight 1000 and 1500 gm with respiratory distress syndrome requiring mechanical ventilation and an inspired oxygen concentration 0.4 or greater were randomly assigned to either a single intratracheal dose of saline or surfactant-TA prior to 8 hours of age. Radiographs obtained prior to treatment and 24 hours after treatment were reviewed by a radiologist (N.T.G.) without knowledge of treatment group. Evaluation consisted of a score including criteria for inflation of the lungs, density of the lungs, and extent of air bronchograms. Pneumothorax, pulmonary interstitial emphysema, and asymmetric parenchymal involvement were noted as well. No significant difference in CXR scores were noted in the two groups, before or after treatment. There was a greater incidence of pneumothorax and pulmonary interstitial emphysema in the control infants, which supports the role of surfactant in preventing barotrauma. Increased incidence of asymmetric parenchymal involvement was noted in the surfactant-treated infants. Further study of the possibility of drug maldistribution is warranted.
Soll
R F
RF
Department of Pediatrics, University of Vermont College of Medicine, Burlington 05405.
Horbar
J D
JD
Griscom
N T
NT
Barth
R A
RA
Lucey
J F
JF
Taeusch
H W
HW
D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008168:Lung / Q000000981:diagnostic imaging / Q000187:drug effects*; D008297:Male; D011030:Pneumothorax / Q000188:drug therapy; D011656:Pulmonary Emphysema / Q000188:drug therapy; D011663:Pulmonary Surfactants / Q000627:therapeutic use*; D011859:Radiography; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy*; D012189:Retrospective Studies; D013997:Time Factors
D011663:Pulmonary Surfactants