Secondary surfactant administration in neonates with respiratory decompensation.
OBJECTIVE
To evaluate blood gases and ventilatory parameters before and after two doses of surfactant in premature infants with respiratory decompensation after recovery from primary respiratory distress syndrome (RDS).


METHODS
This prospective pilot study enrolled infant's > or =500 g birth weight, from 7 days to 3 months of age, with a secondary respiratory decompensation lasting at least 4 h prior to study entry. Infants received two doses of surfactant, 12 h apart.


RESULTS
A total of 20 neonates qualified for secondary surfactant administration. PCO2 (P<0.001); pH (P<0.001); mean airway pressure (P<0.05); FiO2 (P<0.05); modified ventilatory indices (P<0.004) and respiratory severity scores (P<0.001) improved significantly at both 12 and 24 h after surfactant administration.


CONCLUSIONS
Secondary surfactant administration may be effective in reducing short-term ventilatory requirements in neonates who have a respiratory decompensation after recovery from initial RDS. Randomized controlled trials are needed to confirm these preliminary findings.
Bissinger
R
R
Department of Nursing, Medical University of South Carolina, Charleston, SC, USA. bissinrl@musc.edu
Carlson
C
C
Michel
Y
Y
Dooley
C
C
Hulsey
T
T
Jenkins
D
D
D000293:Adolescent; D000328:Adult; D001784:Blood Gas Analysis; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010865:Pilot Projects; D011175:Positive-Pressure Respiration / Q000379:methods*; D011247:Pregnancy; D011663:Pulmonary Surfactants / Q000008:administration & dosage*; D012127:Respiratory Distress Syndrome, Newborn / Q000097:blood / Q000188:drug therapy*; D016896:Treatment Outcome
D011663:Pulmonary Surfactants