Verder H, Albertsen P, Ebbesen F, Greisen G, Robertson B, Bertelsen A, Agertoft L, Djernes B, Nathan E, Reinholdt J
Departments of Pediatrics, Holbaek Central Hospital, Denmark.
Pediatrics. 1999 Feb;103(2):E24. doi: 10.1542/peds.103.2.e24.
To determine whether early versus late treatment with porcine surfactant (Curosurf) reduces the requirement of mechanical ventilation in very preterm infants primarily supported by nasal continuous positive airway pressure (nasal CPAP).
Multicenter randomized, controlled trial.
The study population comprised 60 infants <30 weeks' gestation with respiratory distress syndrome (RDS) who had an arterial to alveolar oxygen tension ratio (a/APO2) of 0.35 to 0.22. The cohort from which the study population was generated comprised 397 infants.
The need for mechanical ventilation or death within 7 days of age was reduced from 63% in the late-treated infants to 21% in early-treated infants. Increasing numbers of antenatal steroid doses also improved the outcome, especially in the early-treated infants. Six hours after randomization mean a/APO2 rose to 0.48 in the early-treated infants compared with 0.36 in the late-treated. The need of mechanical ventilation before discharge was reduced from 68% in the late-treated to 25% in the early-treated infants.
Nasal CPAP in combination with early treatment with Curosurf significantly improves oxygenation and reduces the subsequent need for mechanical ventilation in infants <30 weeks' gestational age with RDS.
确定猪肺表面活性物质（珂立苏）早期治疗与晚期治疗相比，是否能降低主要依靠经鼻持续气道正压通气（经鼻CPAP）支持的极早产儿机械通气的需求。
多中心随机对照试验。
研究人群包括60例孕周<30周、患有呼吸窘迫综合征（RDS）且动脉血氧分压与肺泡血氧分压比值（a/APO2）为0.35至0.22的婴儿。产生研究人群的队列包括397例婴儿。
7日龄内机械通气需求或死亡发生率从晚期治疗组婴儿的63%降至早期治疗组婴儿的21%。产前使用类固醇剂量增加也改善了结局，尤其是在早期治疗组婴儿中。随机分组6小时后，早期治疗组婴儿的平均a/APO2升至0.48，而晚期治疗组为0.36。出院前机械通气需求从晚期治疗组的68%降至早期治疗组的25%。
经鼻CPAP联合早期使用珂立苏治疗可显著改善<30周胎龄RDS婴儿的氧合，并降低其随后对机械通气的需求。
