Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, ON, Canada.
Department of Pediatrics, McMaster Children's Hospital, Hamilton, ON, Canada.
J Perinatol. 2021 Jan;41(1):39-46. doi: 10.1038/s41372-020-00779-9. Epub 2020 Aug 13.
To identify characteristics and outcomes of infants who received multiple doses of surfactant vs those who received one dose or none.
In this retrospective study, we included neonates of 22-28 weeks' gestation admitted to NICUs in the Canadian Neonatal Network. Patients were divided into three groups: no surfactant, single dose, and multiple doses. The primary outcome was a composite of mortality or any of the major morbidities, including severe neurological injury, bronchopulmonary dysplasia, or ≥stage 3 retinopathy of prematurity.
Of 8024 eligible neonates, 2461 (31%) did not receive surfactant, 3545 (44%) received one dose, and 2018 (25%) received >1 dose. Receiving one or more doses of surfactant was associated with significantly higher adjusted odds of mortality or major morbidities in a dose-dependent manner.
Receiving one or more doses of surfactant was associated with adverse neonatal outcomes. Receipt of more than one dose may reflect underlying severe lung immaturity.
确定接受多次肺表面活性剂治疗与单次或未接受肺表面活性剂治疗的婴儿的特征和结局。
在这项回顾性研究中，我们纳入了加拿大新生儿网络中 22-28 周胎龄新生儿重症监护病房收治的新生儿。患者分为三组：未使用肺表面活性剂组、单次剂量组和多次剂量组。主要结局是死亡率或任何主要并发症的复合结局，包括严重神经损伤、支气管肺发育不良或早产儿视网膜病变≥3 期。
在 8024 名符合条件的新生儿中，2461 名（31%）未接受肺表面活性剂治疗，3545 名（44%）接受了单次剂量治疗，2018 名（25%）接受了>1 次剂量治疗。接受一次或多次肺表面活性剂治疗与死亡率或主要并发症的调整后比值比显著相关，呈剂量依赖性。
接受一次或多次肺表面活性剂治疗与新生儿不良结局相关。接受超过一剂可能反映了潜在的严重肺不成熟。
