The effects of synthetic and natural surfactant on fluid balance in acute respiratory distress syndrome.
To evaluate the effect of different surfactants on fluid balance in respiratory distress syndrome, we studied 24 premature infants who were randomised to receive either natural or synthetic surfactant. Data were collected on ventilatory parameters, daily urine output, daily weight, fluid intake and serum electrolytes. Ventilatory requirements decreased more rapidly in babies receiving natural surfactant, with significantly greater reductions in mean airway pressure from 1 to 48 h and oxygenation index from 1-18 h (P < 0.05). There were no differences in fluid intake and serum electrolytes. Mean daily urine output was higher in the group receiving natural surfactant (87 ml versus 61 ml, P < 0.05). This group also had a greater weight loss from birth weight (-146 g versus -65 g, P < 0.05).


CONCLUSIONS
Natural surfactant produces an earlier reduction in ventilatory requirements with an earlier diuresis. This should influence fluid management in respiratory distress syndrome.
Murdoch
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Elizabeth Ward, Garden House Children's Unit, Royal London Hospital, Whitechapel, London, UK.
Kempley
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D001688:Biological Products; D001724:Birth Weight; D004231:Diuresis / Q000187:drug effects*; D004338:Drug Combinations; D005233:Fatty Alcohols / Q000627:therapeutic use; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008131:London; D010743:Phospholipids; D010767:Phosphorylcholine; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011663:Pulmonary Surfactants / Q000008:administration & dosage / Q000627:therapeutic use*; D012127:Respiratory Distress Syndrome, Newborn / Q000503:physiopathology* / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D014882:Water-Electrolyte Balance / Q000187:drug effects*
D001688:Biological Products; D004338:Drug Combinations; D005233:Fatty Alcohols; D010743:Phospholipids; D011663:Pulmonary Surfactants; D010767:Phosphorylcholine; D011092:Polyethylene Glycols; C047049:dipalmitoylphosphatidylcholine, hexadecanol, tyloxapol drug combination; C068291:poractant alfa