Abstract
We conducted a prospective, randomized, controlled trial comparing the efficacy of two doses of a reconstituted bovine surfactant (Surfactant TA) in premature infants requiring mechanical ventilation shortly after birth for respiratory distress syndrome. Forty-six infants weighing 1000–1499 g were randomized into two groups: a low-dose group (23 infants given a single dose of 60 mg surfactant lipid/kg) and a high-dose group (23 infants given a single dose of 120 mg/kg). The mean (SD) age at which surfactant was given was 5.5 (±1.2) h in the low-dose group and 6.0 (±1.5) h in the high dose group. Both treatments improved oxygenation (increased arterial-alvcolar PO2 ratio) with decreased mean airway pressure, the high-dose surfactant having a more beneficial effect in prolonging the response. Infants in the high-dose group had significantly less (P<0.05) incidence of both intraventricular haemorrhage and bronchopulmonary dysplasia. This prospective trial documents that a greater benefit can be obtained by increasing the dose of surfactant (120 mg/kg) beyond 60 mg/kg in the treatment of premature infants with severe respiratory distress syndrome (RDS).
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Abbreviations
- RDS:
-
respiratory distress syndrome
- Surfactant TA:
-
Surfactant Tokyo-Akita
- 5 kDa:
-
5 kilodaltons
- ELISA:
-
enzyme-linked immunosorbent assay
- PDA:
-
patent ductus arteriosus
- a/APO2 :
-
arterial-alveolar oxygen tension ratio
- MAP:
-
mean airway pressure
- 99mIc-DTPA:
-
99m technetium diethylenetriamine pentacetate
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Konishi, M., Fujiwara, T., Naito, T. et al. Surfactant replacement therapy in neonatal respiratory distress syndrome. Eur J Pediatr 147, 20–25 (1988). https://doi.org/10.1007/BF00442605
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DOI: https://doi.org/10.1007/BF00442605