Exogenous surfactant therapy for neonatal respiratory distress syndrome: a two-year clinical experience

The purpose of this study were to gain local experience, to find out the efficacy and side effects of surfactant and to find out whether surfactant therapy will lower the mortality and morbidity of premature infants. From Nov. 1992 to Dec. 1994, there were 25 premature infants in his neonatal intensive care unit (NICU) enrolled in this study. Another 25 premature infants with study group matched gestational age, weight, and Apgar score, who had been previously treated at this NICU from 1990 to 1992 served as control group. Modified bovine surfactant (Survanta, Abbot), 100 mg/Kg of surfactant phospholipid in 4 ml solution was administered intratracheally in four divided doses. The premature infants in the study group had prompt and sustained improvement in oxygenation. The improvement in FiO2 and arterial-to-alveolar oxygen tension ratio (a/APO2) were significantly different from the control infants from 12 hours post-treatment till the subsequent 48 hours after treatment. There was no difference in mortality rate between the two groups. There was no side effect noted from surfactant therapy. It was therefore concluded that modified bovine surfactant therapy is safe and effective for neonates with respiratory distress syndrome. A larger study is required to find out whether it lowers the mortality and morbidity in premature infants in Taiwan.