Gadzinowski J, Szymankiewicz M, Twarowska I, Halliday H
Kliniki Neonatologii Instytutu Ginekologii i Połoznictwa Akademii Medycznej, Poznaniu.
Ginekol Pol. 1992;63(3):101-4.
Twenty seven preterm babies enrolled in a European Multicentre Trial (Curosurf 4) were treated with surfactant Curosurf (Chiesi Farmaceutici, Italy). Mean gestational age was 30.7 weeks (range 26-36), and mean birthweight 1617 g (960-2790 g). Curosurf was given as a rescue therapy in babies with severe RDS between 2-72 hours after birth. Indications for treatment were: clinical and radiological diagnosis of RDS, need for mechanical ventilation and arterial to alveolar oxygen tension ratio < 0.22. Umbilical arterial catheterisation and written parental consent were obtained before trial entry. The results are given for all treated babies and have not been analysed according to the dose of Curosurf. In the first hour after treatment there were mean increases in PaO2 of 27.4 mm Hg (3.6 kPa), and oxygen saturation of 8.2%, a mean decrease in PaCO2 of 15.0 mm Hg (3.3 kPa) and mean increases a/A ratio of 0.1. It was possible to reduce mechanical ventilation one hour after Curosurf instillation: inspired oxygen concentration was decreased by a mean of 12.3%, peak inspiratory pressure by 4.3 cm H2O, and frequency by a mean of 5.6 per minute. It is concluded that there are immediate beneficial effects of Curosurf in preterm babies with severe RDS.
27名参加欧洲多中心试验（珂立苏4）的早产儿接受了珂立苏（意大利基耶西制药公司生产）治疗。平均胎龄为30.7周（范围26 - 36周），平均出生体重为1617克（960 - 2790克）。珂立苏作为出生后2至72小时内患有严重呼吸窘迫综合征（RDS）婴儿的抢救治疗药物。治疗指征为：RDS的临床和放射学诊断、需要机械通气以及动脉血氧分压与肺泡氧分压比值<0.22。在试验入组前进行了脐动脉插管并获得了家长的书面同意。给出的是所有接受治疗婴儿的结果，且未根据珂立苏的剂量进行分析。治疗后第一小时，动脉血氧分压（PaO2）平均升高27.4毫米汞柱（3.6千帕），血氧饱和度平均升高8.2%，动脉血二氧化碳分压（PaCO2）平均降低15.0毫米汞柱（3.3千帕），动脉血氧分压与肺泡氧分压比值（a/A）平均升高0.1。在滴入珂立苏一小时后有可能减少机械通气：吸入氧浓度平均降低12.3%，吸气峰压降低4.3厘米水柱，频率平均降低每分钟5.6次。结论是珂立苏对患有严重RDS的早产儿有即刻有益作用。
