表面活性剂能否影响呼吸衰竭的足月婴儿的死亡率和发病率？
Can surfactants affect mortality and morbidity in term infants with respiratory failure?
机构信息
Division of Neonatology, Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital,University of Health Sciences Turkey, İzmir, Turkey ; Department of Pediatrics, Division of Neonatology, İzmir Faculty of Medicine, University of Health Sciences Turkey, İzmir, Turkey.
Department of Pediatrics, Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital,University of Health Sciences Turkey, İzmir, Turkey.
出版信息
Turk J Med Sci. 2022 Dec;52(6):1779-1784. doi: 10.55730/1300-0144.5523. Epub 2022 Dec 21.
BACKGROUND
We aimed to discuss term infants who are given surfactant due to respiratory disorder according to the underlying etiology, the dose of surfactant administration, and the need for repeated surfactant administration.
METHODS
In this retrospective study infants hospitalized in the 4th level neonatal intensive care unit during January 2019 and December 2021 and administered surfactant due to respiratory distress were included. Term infants given surfactant due to respiratory failure were included in the study through the data recording system. The number of surfactant doses, indications for administration, mortality, duration of hospitalization, intubation time, and inotrope use were recorded in the infants included in the study.
RESULTS
: During the two-year period, 1250 infants were hospitalized in our neonatal intensive care unit. Of those, 56 infants received surfactant replacement therapy for severe respiratory failure. There were 30 infants with pneumonia, 4 infants with meconium aspiration syndrome (MAS), and 22 infants with transient tachypnea of the newborn (TTN). It was seen that single-dose administration was higher in patients with TTN (p = 0.01), while multiple-dose surfactant administration was more common in patients with MAS, resulting in a statistical difference (p = 0.02). Mortality was lower, especially in cases given early surfactant administration and this situation was statistically significant (p < 0.001). Duration of intubation was 5.05 ± 4.7 days in early surfactant administration group and 8.0 ± 6.1 days in late surfactant administration group. This difference was statistically significant (p = 0.04). While early surfactant application was statistically higher in the TTN group (p = 0.007), late surfactant application was statistically higher in the pneumonia group (p = 0.001).
DISCUSSION
Despite the difference on administration time and repeat dose interval due to etiology, surfactant treatment is improving the respiratory distress of term infants.
背景
本研究旨在根据潜在病因、表面活性物质（PS）剂量和重复 PS 给药的需求，讨论因呼吸障碍而接受 PS 治疗的足月婴儿。
方法
本回顾性研究纳入了 2019 年 1 月至 2021 年 12 月期间在 4 级新生儿重症监护病房住院且因呼吸窘迫接受 PS 治疗的婴儿。通过数据记录系统纳入因呼吸衰竭接受 PS 治疗的足月儿。记录纳入研究的婴儿的 PS 剂量、给药指征、死亡率、住院时间、插管时间和使用儿茶酚胺的情况。
结果
在这两年期间，我院新生儿重症监护病房共收治 1250 例婴儿。其中 56 例因严重呼吸衰竭接受 PS 替代治疗。肺炎 30 例，胎粪吸入综合征（MAS）4 例，新生儿暂时性呼吸增快（TTN）22 例。TTN 患者单次给药比例较高（p = 0.01），MAS 患者多剂量 PS 给药比例较高，差异有统计学意义（p = 0.02）。早期 PS 治疗的死亡率较低，差异有统计学意义（p < 0.001）。早期 PS 治疗组的插管时间为 5.05 ± 4.7 天，晚期 PS 治疗组为 8.0 ± 6.1 天。差异有统计学意义（p = 0.04）。TTN 组早期 PS 应用比例较高（p = 0.007），肺炎组晚期 PS 应用比例较高（p = 0.001）。
讨论
尽管由于病因不同，PS 给药时间和重复剂量间隔存在差异，但 PS 治疗确实改善了足月婴儿的呼吸窘迫。
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