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The outcome of surfactant replacement therapy in above nearterm neonates with severe pulmonary disease

Korean Journal of Pediatrics 2007;50(12):1200-1205.
Published online December 15, 2007.
The outcome of surfactant replacement therapy in above nearterm neonates with severe pulmonary disease
Su-Min Shon, Bo-Young Lee, Chun-Soo Kim, Sang-Lak Lee, Tae-Chan Kwon
Departments of Pediatrics, Keimyung University School of Medicine, Daegu, Korea
준 만삭 이상아에서 폐표면 활성제 보충요법의 성적
손수민, 이보영, 김천수, 이상락, 권태찬
계명대학교 의과대학 소아과학교실
Correspondence: 
Bo-Young Lee, Email: e-bbnii@hanmail.net
Abstract
Purpose
: We performed this study to investigate the outcome of surfactant replacement therapy (SRT) in above nearterm neonates who were required mechanical ventilatory care due to meconium aspiration pneumonia (MAP), respiratory distress syndrome (RDS) or other severe pneumonia (PN).
Methods
: 48 patients, gestational period ≥36 weeks, who were admitted in NICU of Dongsan Medical Center, Keimyung University between July 1999 and June 2004 were enrolled. They were divided into three groups, MAP group (15 cases), RDS group (27 cases) and PN group (6 cases). All patients were received SRT and evaluated several clinical data (gestational age, oxygen index, duration of ventilator care) and outcome (complications and mortality rate) between pre-SRT and post-SRT. The mean dose of surfactant (modified bovine surfactant, Newfacten, Yuhan Co., Seoul, Korea) was 120 mg/kg.
Results
: Among each groups, mean pre-SRT OI was higher in MAP group (21±3.2) than other groups, mean duration (days) of ventilatory care and oxygen therapy were similar distributions. Compared with pre-SRT values, significant improvements (P<0.05) in mean values for FiO2 and oxygenation index were documented at 12 hours after SRT. Early complications (persistent pulmonary hypertension of newborm, pneumothorax) and survival rate were lower in MAP group. Within RDS group, earlier SRT (given before 12 hours of life) revealed significantly lower early complication rate than later SRT (given after 12 hours of life) (13.3% vs 58.3%, P<0.05)
Conclusion
: Our study suggested that SRT seems to be an effective therapy in above nearterm neonates with severe pulmonary disease, and earlier SRT tends to reduce complications in RDS group than later therapy.
Key Words: Nearterm neonate, Surfactant replacement therapy


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