Koch Lutz, Frommhold David, Beedgen Bernd, Ruef Peter, Poeschl Johannes
Division of Neonatology, Department of Pediatrics, University of Heidelberg Medical School, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany.
Crit Care Res Pract. 2010;2010. doi: 10.1155/2010/235894. Epub 2010 Jun 7.
Objective. To investigate whether prophylactic surfactant administration is superior over selective treatment in preterm infants with respiratory distress syndrome (RDS). Methods. In our retrospective analysis, we compared premature infants (23 + 0 to 26 + 6 weeks) receiving 200 mg/kg surfactant (curosurf(®)) within five minutes after birth (prophylactic group, N = 31) with those infants who received surfactant therapy for established RDS (selective group, N = 34). Results. Prophylactic therapy significantly decreased the need for mechanical ventilation (74 hours per patient versus 171 hours per patient, resp.). We observed a reduced incidence of interstitial emphysema (0% versus 9%, resp.), pneumothoraces (3% versus 9%, resp.), chronic lung disease (26% versus 38%, resp.), and surfactant doses per patient (1.3 versus 1.8, resp.), although those variables did not reach significance. Conclusion. We conclude that infants under 27 weeks' gestation profit from prophylactic surfactant administration by reducing the time of mechanical ventilation. This in turn could contribute to reduce the risk for mechanical ventilation associated complications, without any detrimental short-term side effects.
目的。探讨预防性应用表面活性剂对呼吸窘迫综合征（RDS）早产儿是否优于选择性治疗。方法。在我们的回顾性分析中，我们将出生后5分钟内接受200mg/kg表面活性剂（珂立苏（®））的早产儿（23⁺⁰至26⁺⁶周）（预防组，N = 31）与接受表面活性剂治疗已确诊RDS的婴儿（选择组，N = 34）进行了比较。结果。预防性治疗显著减少了机械通气的需求（分别为每位患者74小时和171小时）。我们观察到间质性肺气肿（分别为0%和9%）、气胸（分别为3%和9%）、慢性肺病（分别为26%和38%）的发生率以及每位患者表面活性剂剂量（分别为1.3和1.8）有所降低，尽管这些变量未达到显著差异。结论。我们得出结论，孕周小于27周的婴儿通过预防性应用表面活性剂减少机械通气时间而获益。这反过来可能有助于降低机械通气相关并发症的风险，且无任何有害的短期副作用。
