Zhonghua Er Ke Za Zhi. 2014 Oct;52(10):724-8.
To investigate the efficacy and safety of surfactant when it was used to treat late-preterm or term infants with respiratory distress syndrome (RDS).
Infants who were born at ≥34 weeks' gestational age and diagnosed with respiratory distress syndrome, required mechanical ventilation, admitted to 8 tertiary NICUs at <72 hours of age were enrolled. Surfactant was given if the infant required FiO2≥0.4 to maintain PaO2≥50 mmHg(1 mmHg=0.133 kPa) or SpO2>90%. Before and after surfactant treatment, the results of blood gas, ventilator settings, and the incidence of complications were recorded and analyzed. Comparison between continuous variables was made by t-test or one way analysis of variance (ANOVA). Categorical data was analyzed by a 2-tailed Pearson χ2 test.
Totally 96 infants were enrolled in this prospective study. The mean gestational age was (36.5±2.1) weeks. Of whom, 71.9% (n=69) were male, 59.4% (n=57) were late-preterm infants, 62.5% (n=60) were delivered by elective cesarean section. The first dose of surfactant was given at the median age of 13.3 hours with the dosage of (109±20) mg/kg. The second dose was given to 10.4% (n=10) infants. Half an hour post surfactant, PaO2/FiO2, OI, A-aDO2, PaO2/PAO2 improved significantly, and lasted for 6 hours. The mean length of hospital stay was (19±9) days, median medical cost was (39,000±36,000) yuan. Totally 73 cases (76.0%) were discharged after the treatment completed. Compared to small dosage, the improvement of PaO2/FiO2, OI, A-aDO2, PaO2/PAO2 was more significant at 6 hours after relatively large dose (≥100 mg/kg) of surfactant, and the length of mechanical ventilation was shorter. But the length of hospital stay, medical costs, and the incidence of complications was not significantly different between these two dosage groups.
Surfactant significantly improved the oxygenation in late-preterm or term infants with respiratory distress syndrome.
探讨表面活性剂用于治疗晚期早产儿或足月儿呼吸窘迫综合征（RDS）的有效性和安全性。
纳入胎龄≥34周、诊断为呼吸窘迫综合征、需要机械通气且在出生后<72小时入住8家三级新生儿重症监护病房（NICU）的婴儿。如果婴儿需要FiO2≥0.4以维持PaO2≥50 mmHg（1 mmHg = 0.133 kPa）或SpO2>90%，则给予表面活性剂。记录并分析表面活性剂治疗前后的血气结果、呼吸机设置及并发症发生率。连续变量采用t检验或单因素方差分析（ANOVA）进行比较。分类数据采用双侧Pearson χ2检验进行分析。
本前瞻性研究共纳入96例婴儿。平均胎龄为（36.5±2.1）周。其中，71.9%（n = 69）为男性，59.4%（n = 57）为晚期早产儿，62.5%（n = 60）通过择期剖宫产分娩。首剂表面活性剂给药的中位年龄为13.3小时，剂量为（109±20）mg/kg。10.4%（n = 10）的婴儿给予了第二剂。表面活性剂给药后半小时，PaO2/FiO2、OI、A-aDO2、PaO2/PAO2显著改善，并持续6小时。平均住院时间为（19±9）天，中位医疗费用为（39,000±36,000）元。治疗结束后，共有73例（76.0%）出院。与小剂量相比，较大剂量（≥100 mg/kg）表面活性剂给药后6小时，PaO2/FiO2、OI、A-aDO2、PaO2/PAO2的改善更显著，机械通气时间更短。但这两个剂量组之间的住院时间、医疗费用及并发症发生率无显著差异。
表面活性剂可显著改善晚期早产儿或足月儿呼吸窘迫综合征的氧合情况。
