Segerer, Hugo and Stevens, P. and Schadow, B. and Maier, R. and Kattner, E. and Schwarz, H. and Curstedt, T. and Robertson, B. and Obladen, Michael
Surfactant substitution in ventilated very low birth weight infants: factors related to response types.
Pediatric research 30 (6), pp. 591-596.
We investigated factors than may influence the response to surfactant substitution. Thirty-five very low birth weight infants with respiratory distress syndrome were treated with Curosurf at 3-12 h of age. From the changes in oxygenation, the therapeutic response was categorized as rapid and sustained, rapid with relapse, or poor. Phospholipids and surfactant protein A were quantified in gastric aspirate samples obtained immediately after birth. They showed that 16 infants had accelerated lung maturity, despite clinical and radiologic signs of respiratory distress syndrome. Ten of them had suffered from birth asphyxia or connatal infection. Nevertheless, 12 of these 16 infants responded rapidly to surfactant substitution. Poor response was seen in four infants with connatal infection. Of 19 infants with immature lung profile, 18 showed a rapid initial response to surfactant substitution. Dynamic compliance of the respiratory system or arterial blood pressure before substitution, the ultrastructure of the surfactant preparation, or persistence of the ductus arteriosus did not influence the response type, but fraction of inspired oxygen was higher before surfactant substitution in infants with poor response. Prognosis was related to short-term response: Of 17 infants who showed a rapid and sustained response, none died, whereas eight of 18 infants with relapse after rapid initial response or poor response died (p less than 0.05). We conclude that surfactant substitution may be beneficial not only in babies with primary surfactant deficiency but also in other pulmonary disorders that are common in very low birth weight infants. The type of response may be of prognostic value.
|Institutions:|| Medicine > Lehrstuhl für Kinder- und Jugendmedizin|
|Ductus Arteriosus, Patent/complications||MESH|
|Infant, Low Birth Weight||MESH|
|Pulmonary Surfactants/therapeutic use||MESH|
|Respiratory Distress Syndrome, Newborn/drug therapy||MESH|
|Subjects:||600 Technology > 610 Medical sciences Medicine|
|Created at the University of Regensburg:||Unknown|
|Deposited On:||11 May 2011 05:53|
|Last Modified:||21 Jul 2011 02:13|