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Surfactant replacement therapy in neonatal respiratory distress syndrome.

Journal of the Korean Pediatric Society 1991;34(9):1211-1222.
Published online September 30, 1991.
Surfactant replacement therapy in neonatal respiratory distress syndrome.
Chan Ok Park, Boung Yul Lim, Byeong Gie Yeo, Ji Ho Song, Eun Kyung Sohn, Chong Woo Bae, Sa Jun Chung, Chang Il Ahn
Department of Pediatrics, College of Medicine, Kyung Hee University, Seoul, Korea
신생 아 Respiratory Distress Syndrome에서 Surfactant 보충 요법 - 치료군과 대조군의 임상적 비교 관찰 -
박찬옥, 임병열, 여병기, 송지호, 손은경, 배종우, 정사준, 안창일
경희대학교 의과대학 소아과학교실
Received: 20 March 1991   • Accepted: 22 May 1991
Abstract
Respiratory distress syndrome (RDS) in tiny infants remains a major medical challenge as they are less tolerant of supportive care. In 1959, after identification of the pulmonary surfactant (S), S replacement therapy were used to treat RDS. This idea was first successfully tested on RDS infants by Fujiwara, et. al” in 1980. Now the trial and use of S for the treatment in RDS is also popular in other countries. We conducted a clinical trial of reconstitued bovine S(S-TA) comparing its efficacy in RDS. S-treated group of 6 neonates and control group of 8 neonates were involved this study. The results were as follows; 1) During the replacement of S through the endotracheal tube, hypoxia or hypercarbia were not noticed, and a dramatic elevation of PaO2 appeared. 2) After replacement of S, there were significantly improved oxygenation (increased arterial- alveolar O2 ratio) and chest roentgenographic findings, with decreased mean airway pressure and a fraction of inspired oxygen in the S-treated group, unlike the control group. 3) Infants in the S-treated group had a more beneficial effect in the shortening of the duration of oxygenation, mechanical ventilator care and timing of extubation of the endotracheal tube. 4) Infants in the S-treated group had less mortality and late complications than the infants in the control group. In conclusion, exogenous S replacement produced exellent results, which decreased pressure, oxygen concentration and improved chest X-ray findings during ventilator care in the acute stage. Also, there were decreased incidence of pulmonary and/or other complications during the late stage. So, S replacement will become a important advance in the care of preterm infants with severe RDS.
Key Words: Neonatal Respiratory Distress Syndrome, Surfactant Replacement


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