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Development of chronic lung disease in preterm infants treated with surfactant

Majeda S Hammoud1, Lukman Thalib

  • 1Monash Medical Center, Monash University, Victoria, Australia. m.hammoud@hsc.kuniv.edu.kw

Pediatrics International : Official Journal of the Japan Pediatric Society
|September 13, 2002
PubMed

Insights

Infants with severe respiratory distress syndrome (RDS) treated with two surfactant doses showed better lung outcomes than those with mild RDS receiving one dose. This suggests surfactant dosage may influence chronic lung disease development in preterm infants.

Area of Science:

  • Neonatal Medicine
  • Respiratory Physiology
  • Pediatric Pulmonology

Background:

  • Chronic lung disease (CLD) commonly affects preterm infants with severe respiratory distress syndrome (RDS).
  • Surfactant replacement therapy is a proven treatment for RDS, with varying doses used.
  • This study investigates the impact of surfactant dosage on CLD development in preterm infants.

Purpose of the Study:

  • To evaluate the effect of one versus two doses of surfactant on the later development of chronic lung disease (CLD).
  • To compare respiratory outcomes in preterm infants with mild versus severe RDS treated with surfactant.

Main Methods:

  • Retrospective analysis of case records for preterm infants born at or before 28 weeks gestation.
  • Inclusion of infants treated with natural surfactant (Survanta) between September 1994 and April 1996.
  • Comparison of respiratory outcomes at corrected gestational age of 36 weeks based on initial RDS severity and surfactant dosage.

Main Results:

  • Infants with severe RDS receiving two surfactant doses showed a trend towards better respiratory outcomes compared to those with mild RDS receiving one dose.
  • At 36 weeks corrected gestational age, 54% of infants with mild RDS required oxygen, versus 44% of those with severe RDS.
  • These findings suggest a potential benefit of higher surfactant dosage in mitigating CLD.

Conclusions:

  • Infants with severe RDS treated with surfactant responded comparably or better than those with mild RDS regarding CLD development.
  • Surfactant treatment's efficacy in preventing CLD may be proportional to the initial RDS severity and administered dosage.
  • Further research is warranted to optimize surfactant therapy protocols for preterm infants.
Abstract

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