[Surfactant substitution in severe respiratory distress syndrome in premature infants weighing less than 1,000 g].
19 preterm infants with severe respiratory distress syndrome (RDS) were treated with a single dose of natural porcine surfactant (Curosurf, 200 mg/kg). 9 patients had a birth weight of less than 1000 g (845 +/- 112 g, mean +/- SD and the mean gestational age was 27.2 +/- 2.1 weeks). The other 10 had a birth weight of greater than 1000 g (1521 +/- 218 g and a mean gestational age 31 +/- 2.8 weeks). Age at treatment was 3 h in infants less than 1000 g and 4 h in patients greater than 1000 g. Both groups of infants showed a rapid improvement in oxygenation and gas exchange within minutes after surfactant replacement. Exposition to greater than 60% and greater than 40% oxygen was identical in both groups. However, time in greater than 21% oxygen was significantly longer in infants less than 1000 g (median 30 days, 8.5 days in patients greater than 1000 g, p less than 0.01). The duration of mechanical ventilation was 33 days, in patients greater than 1000 g and 5 days; p less than 0.01. None of the infants developed a pneumothorax, but 6 out of 9 patients less than 1000 g developed mild bronchopulmonary dysplasia. 2 infants less than 1000 g died at day 5 and day 11 from cardio-circulatory arrest following ligation of a patent ductus arteriosus, and nosocomial septicaemia, respectively. Prolonged mechanical ventilation and exposure to oxygen in patients less than 1000 g cannot be attributed to surfactant deficiency alone.(ABSTRACT TRUNCATED AT 250 WORDS)
Universitäts-Kinderklinik Göttingen.
C P
CP
Speer
K
K
Harms
E
E
Herting
F
F
Müller
W
W
Schröter
A T
AT
Teichmann
N
N
Neumann
T
T
Curstedt
B
B
Robertson
D001724:Birth Weight; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D015337:Multicenter Studies as Topic; D011175:Positive-Pressure Respiration; D011663:Pulmonary Surfactants / Q000008:administration & dosage*; D011859:Radiography; D012127:Respiratory Distress Syndrome, Newborn / Q000000981:diagnostic imaging / Q000628:therapy*
D011663:Pulmonary Surfactants
Surfactant-Substitution beim schweren Atemnotsyndrom Frühgeborener less than 1000 g.