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Respiratory function at follow-up after neonatal surfactant replacement therapy
B Yuksel1, A Greenough, H R Gamsu
1Department of Child Health, King's College Hospital, London, U.K.
Insights
Surfactant replacement therapy in preterm infants improved lung function at follow-up. This treatment reduced airways resistance (RAW) and increased specific airways conductance (SGAW).
Area of Science:
- Neonatology
- Pediatric Pulmonology
- Respiratory Physiology
Background:
- Preterm infants often experience respiratory distress due to immature lungs.
- Surfactant replacement therapy is used to improve lung function in neonates.
- Long-term effects of prophylactic surfactant therapy on respiratory mechanics require further investigation.
Purpose of the Study:
- To assess the long-term respiratory function in preterm infants following prophylactic surfactant replacement therapy.
- To compare lung function parameters between infants who received surfactant and those who received placebo.
Main Methods:
- A multi-center randomized placebo-controlled trial was conducted.
- Respiratory function was assessed in 17 preterm infants at a median of 7 months post-neonatal period.
- Measurements included functional residual capacity (FRC), thoracic gas volume (TGV), and airways resistance (RAW), with specific airways conductance (SGAW) calculated.
Main Results:
- No significant differences in FRC or TGV were observed between the surfactant and placebo groups.
- Airways resistance (RAW) was significantly lower in the surfactant group compared to the placebo group (P < 0.05).
- Specific airways conductance (SGAW) was significantly higher in the surfactant group than in the placebo group (P < 0.05).
Conclusions:
- Prophylactic surfactant replacement therapy in preterm infants leads to improved lung function at follow-up.
- The therapy demonstrates a positive impact on specific airways conductance and a reduction in airways resistance.
- These findings support the long-term benefits of surfactant therapy for respiratory health in preterm infants.
Abstract:
Respiratory function was assessed at a median of 7 months (range 6-12) in 17 preterm infants who, in the neonatal period, had been entered into a multi-centre randomized placebo-controlled trial of prophylactic surfactant replacement therapy. Seven infants (median gestational age 28 weeks) received surfactant and the remaining ten infants (median gestational age 27 weeks) placebo. Respiratory function was assessed by measuring functional residual capacity (FRC), thoracic gas volume (TGV) and airways resistance (RAW). Specific conductance (SGAW) was calculated from RAW and TGV. There was no significant difference in FRC or TGV between the two groups. RAW, however, was significantly lower in the surfactant (median 41, range 21-48 cmH2O l-1 s-1) compared to the placebo group (median 57, range 40-68 cmH2O l-1 s-1), P < 0.05 and SGAW significantly higher in the surfactant (median 0.136, range 0.063-0.289 l cmH2O-1 s-1) compared to the placebo group (median 0.081, range 0.062-0.134 l cmH2O-1 s-1), P < 0.05. These results suggest that surfactant replacement therapy improves lung function at follow-up.