Abstract
Objective: Surfactant therapy (ST) has significantly reduced mortality and respiratory morbidities among preterm
infants with respiratory distress syndrome (RDS). However, majority of late preterm and term infants with respiratory
distress also suffer from non-RDS lung diseases. In some of these diseases, secondary surfactant deficiency may
develop and ST can be beneficial. In this study we evaluated the indications and early outcomes of ST in late preterm
and term infants.
Material and Methods: We retrospectively evaluated the medical records of 135 late preterm and term infants who
underwent ST between January 2009 and December 2012. The clinical characteristics of the patients, their diagnoses,
number of surfactant application and time of administration, FiO2 requirements before and after ST (1st and 6th
hours),duration of mechanical ventilation, and mortality rate were evaluated.
Results: Among135 late preterm and term patients treated with ST, 78 (57.8%) were given ST due to lung disease other
than RDS and had longer mechanical ventilator duration. In addition, ≥ 2 doses of surfactant requirement, pulmonary
hypertension and mortality rate were found to be higher in these infants. Among patients with RDS, as expected, FiO2
requirement was found to decrease in the 1st and 6th hours after ST (0.60 to 0.50 & 0.37 and p <0.001). Sixteen
percent of newborns with congenital pneumonia required repeated surfactant doses. The FiO2 requirement after ST
was decreased in 42 patients with congenital pneumonia (0.67 to 0.65 & 0.48 and p <0.001). Sixteen patients with
severe meconium aspiration syndrome (median FiO2; 0.98) and 25 patients supporting with high frequency oscillatory
ventilation (HFOV) support did not benefit from ST (p = 0.71 and p = 0.964).
Conclusion: We observed that ST reduced oxygen requirement in the late preterm and term infants with RDS and
congenital pneumonia. However, we found that ST was not beneficial in the infants who applied HFOV due to severe
respiratory insufficiency. We think that prospective studies involving a larger number of patients are needed to determine
treatment options in these patient groups.
Keywords: Meconium aspiration syndrome, Newborn
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Copyright and license
Copyright © 2020 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.