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Cardiorespiratory and stress hormone responses during first dose surfactant administration in neonates with RDS
J O Chan1, B A Moglia, I V Reeves
1Department of Pediatrics, Pennsylvania State University Children's Hospital, College of Medicine, Milton S. Hershey Medical Center, Hershey 17033.
Pediatric Pulmonology
|April 1, 1994
Summary
Surfactant therapy improved oxygenation in preterm infants with respiratory distress syndrome. However, it did not significantly alter hemodynamic function or further increase catecholamine release, suggesting a maximal stress response prior to treatment.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Pharmacology
Background:
- Preterm infants with Respiratory Distress Syndrome (RDS) exhibit significant stress responses.
- Surfactant administration is a standard treatment for RDS.
Purpose of the Study:
- To compare the immediate physiological effects of Exosurf Neonatal and Survanta in preterm infants.
- To investigate the impact of surfactant therapy on hemodynamic function and catecholamine release.
Main Methods:
- Prospective randomized study comparing Exosurf Neonatal and Survanta.
- Standardized surfactant administration with strict protocol adherence.
- Continuous monitoring of physiological variables, arterial blood gases, and plasma catecholamines before and after treatment.
Main Results:
- Both surfactants improved oxygenation (SaO2, PaO2, OI) similarly.
- No significant changes in mean arterial blood pressure (ABP) were observed.
- Pre-treatment catecholamine levels (norepinephrine, epinephrine) were high, indicating a substantial stress response.
Conclusions:
- Current surfactant administration techniques do not appear to trigger significant further catecholamine surges or acute changes in ABP.
- The lack of response may be due to maximal catecholamine release prior to treatment.