title: [A multicenter study on the surfactant treatment in late-preterm or term infants with respiratory distress syndrome].
abstract: OBJECTIVE
  To investigate the efficacy and safety of surfactant when it was used to treat late-preterm or term infants with respiratory distress syndrome (RDS).
  
  
  METHODS
  Infants who were born at ≥34 weeks' gestational age and diagnosed with respiratory distress syndrome, required mechanical ventilation, admitted to 8 tertiary NICUs at <72 hours of age were enrolled. Surfactant was given if the infant required FiO2≥0.4 to maintain PaO2≥50 mmHg(1 mmHg=0.133 kPa) or SpO2>90%. Before and after surfactant treatment, the results of blood gas, ventilator settings, and the incidence of complications were recorded and analyzed. Comparison between continuous variables was made by t-test or one way analysis of variance (ANOVA). Categorical data was analyzed by a 2-tailed Pearson χ2 test.
  
  
  RESULTS
  Totally 96 infants were enrolled in this prospective study. The mean gestational age was (36.5±2.1) weeks. Of whom, 71.9% (n=69) were male, 59.4% (n=57) were late-preterm infants, 62.5% (n=60) were delivered by elective cesarean section. The first dose of surfactant was given at the median age of 13.3 hours with the dosage of (109±20) mg/kg. The second dose was given to 10.4% (n=10) infants. Half an hour post surfactant, PaO2/FiO2, OI, A-aDO2, PaO2/PAO2 improved significantly, and lasted for 6 hours. The mean length of hospital stay was (19±9) days, median medical cost was (39,000±36,000) yuan. Totally 73 cases (76.0%) were discharged after the treatment completed. Compared to small dosage, the improvement of PaO2/FiO2, OI, A-aDO2, PaO2/PAO2 was more significant at 6 hours after relatively large dose (≥100 mg/kg) of surfactant, and the length of mechanical ventilation was shorter. But the length of hospital stay, medical costs, and the incidence of complications was not significantly different between these two dosage groups.
  
  
  CONCLUSIONS
  Surfactant significantly improved the oxygenation in late-preterm or term infants with respiratory distress syndrome.
mesh_terms: D001784:Blood Gas Analysis; D002585:Cesarean Section; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008297:Male; D011247:Pregnancy; D011446:Prospective Studies; D011663:Pulmonary Surfactants / Q000627:therapeutic use*; D012121:Respiration, Artificial; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy*; D013501:Surface-Active Agents; D047929:Term Birth; D016896:Treatment Outcome
chemical_list: D011663:Pulmonary Surfactants; D013501:Surface-Active Agents