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Early changes in lung function and response to surfactant replacement therapy

A T Gibson1, R A Primhak

  • 1Jessop Hospital for Women, Sheffield University, Department of Paediatrics, UK.

European Journal of Pediatrics
|July 1, 1994
PubMed
Summary
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Artificial surfactant (Exosurf) response varied in preterm infants. Babies with higher initial lung compliance showed lung function deterioration, while those with lower compliance improved. Caution is advised when selecting high-compliance infants for surfactant treatment.

Area of Science:

  • Neonatal Medicine
  • Respiratory Physiology
  • Pediatric Pulmonology

Background:

  • Preterm infants often experience respiratory distress syndrome.
  • Artificial surfactant administration is a common treatment for respiratory distress syndrome.
  • Individual responses to surfactant therapy can vary significantly.

Purpose of the Study:

  • To investigate the impact of initial dynamic respiratory system compliance (Cdyn) on preterm infants' response to artificial surfactant (Exosurf).
  • To analyze changes in Cdyn, oxygenation, and long-term outcomes following surfactant administration based on pre-treatment lung function.

Main Methods:

  • Dynamic respiratory system compliance (Cdyn) was measured in 44 preterm infants before, immediately after, and for 96 hours post-surfactant administration.

Related Experiment Videos

  • Infants were stratified into three groups based on pre-surfactant Cdyn levels.
  • Inspired oxygen and alveolar/arterial oxygen gradients were monitored.

    • Main Results:

    • No significant overall change in Cdyn for the entire group.
    • Infants with the highest initial Cdyn experienced sustained lung function deterioration.
    • Infants with the lowest initial Cdyn showed sustained lung function improvement.
    • Oxygenation parameters differed significantly between groups, with least improvement in those with best initial lung function.
    • No significant differences in long-term oxygen needs or chronic lung disease incidence were observed between groups.

    Conclusions:

    • An infant's lung function prior to surfactant administration influences their response to treatment.
    • Preterm infants with higher initial lung compliance may be at increased risk of deterioration after surfactant.
    • Careful patient selection is recommended for surfactant therapy, particularly for infants with high initial compliance.