title: Respiratory mechanics before and after late artificial surfactant rescue.
abstract: OBJECTIVE
  To assess the effect of late administration of synthetic surfactant (Exosurf) on the ventilatory function of premature infants with hyaline membrane disease (HMD).
  
  
  METHODS
  Prospective non-randomized study in the Neonatal Intensive Care Unit (NICU) of a major referral hospital. The patients included two groups of premature infants with a birthweight between 750 and 2000 g who developed HMD. In group 1 with moderate to severe HMD, 2 x 5 mL/kg doses of Exosurf were given 12 h apart (first dose given at a mean age of 18.7 +/- 3.4 h [mean +/- s.e.m.]). In group 2 with milder HMD, no surfactant was given.
  
  
  RESULTS
  Significant reductions (P < 0.05) in the fraction of inspired oxygen (FIO2) occurred 6 h after surfactant administration (24 h of life) and by 48 h (64 h of life) in group 2. These improvements in gas exchange preceded improvements in passive respiratory compliance which occurred 24 h after surfactant (42 h of life) and by 72 h (88 h of life) in group 2 (P < 0.01). In both groups pulmonary resistance increased and was significant (P < 0.05) by 48 h (66 h of life) in group 1.
  
  
  CONCLUSIONS
  Synthetic surfactant given as late as a mean age 18.7 +/- 3.4 h still improves gas exchange but these early improvements cannot be completely explained by modifications of respiratory compliance.
authors.affiliation: Laboratoire de Physiologie, Universite de Bordeaux 2, France.
authors.forename: D A
authors.initials: DA
authors.lastname: Todd
authors.forename: M L
authors.initials: ML
authors.lastname: Choukroun
authors.forename: M
authors.initials: M
authors.lastname: Fayon
authors.forename: C
authors.initials: C
authors.lastname: Kays
authors.forename: H
authors.initials: H
authors.lastname: Guénard
authors.forename: I
authors.initials: I
authors.lastname: Galpérine
authors.forename: J L
authors.initials: JL
authors.lastname: Demarquez
mesh_terms: D000367:Age Factors; D003131:Combined Modality Therapy; D004338:Drug Combinations; D005233:Fatty Alcohols / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006819:Hyaline Membrane Disease / Q000188:drug therapy* / Q000503:physiopathology; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D010767:Phosphorylcholine; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011446:Prospective Studies; D011663:Pulmonary Surfactants / Q000627:therapeutic use*; D012121:Respiration, Artificial; D015656:Respiratory Mechanics / Q000187:drug effects*
chemical_list: D004338:Drug Combinations; D005233:Fatty Alcohols; D011663:Pulmonary Surfactants; D010767:Phosphorylcholine; D011092:Polyethylene Glycols; C047049:dipalmitoylphosphatidylcholine, hexadecanol, tyloxapol drug combination