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Changing use of surfactant over 6 years and its relationship to chronic lung disease

Euming Chong1, Jay Greenspan, Sharon Kirkby

  • 1Department of Pediatrics, Jefferson Medical College, Philadelphia, PA 19107, USA. euming.chong@mail.tju.edu

Pediatrics
|October 1, 2008
PubMed

Insights

Surfactant use in premature infants decreased, while chronic lung disease rates rose. Infants receiving surfactant were more likely to develop lung disease, but no direct link was established.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Perinatal Research

Background:

  • Surfactant therapy is crucial for respiratory distress syndrome in preterm infants.
  • Trends in surfactant use and its association with chronic lung disease (CLD) require ongoing investigation.
  • Understanding these trends is vital for optimizing care for infants weighing <1000 g.

Purpose of the Study:

  • To analyze the 6-year trend of surfactant administration in very low birth weight infants.
  • To investigate the relationship between surfactant use and the incidence of CLD in this vulnerable population.

Main Methods:

  • Retrospective analysis of the Alere (ParadigmHealth) database (2001-2006).
  • Inclusion of 3086 infants weighing <1000 g.
  • Statistical comparison using chi-squared test, ANOVA, and Student's t-test.

Main Results:

  • Surfactant use declined from 67% (2001) to 59.9% (2006).
  • Infants receiving surfactant, especially multiple doses, showed a higher incidence of CLD.
  • CLD rates increased from 47.8% (2001) to 57.8% (2006); survival rates were similar across groups.

Conclusions:

  • Despite decreased surfactant use and increased CLD rates, a direct causal link was not supported.
  • Infants receiving surfactant had higher CLD likelihood, while rates remained stable in non-surfactant-treated infants.
  • A significant proportion (60%) of infants not receiving surfactant still developed CLD, highlighting a critical concern.
Abstract

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