THE APPLICATION OF
PULMONARY SURFACTANT IN THE LATER PERIOD OF NEONATES WITH RESPIRATORY
DISTRESS SYNDROME AND PNEUMONORRHAGIA
Zhou D-Y, Jiang S-Y, Wang S-W, Liu G-H, Li M, Yan L, Zhao X-S, Peng
M,
Harbin Children's Hospital, Harbin, China
Objective: To explore the effect of the pulmonary
surfactant (PS) on the later period
of neonates with respiratory distress syndrome (NRDS) and with
pneumonorrhagia.
Methods: 5 patients (2 cases with pneumonorrhagia, 3
cases without pneumonorrhagia but with severe symptoms and poor blood gas
index who were given 72-hour-ventilation treatment without becoming better)
were treated with PS by endotracheal administration. We compared the data
of blood gas index and ventilator index of the patients without using PS with
those of patients with using PS.
Results: (1) The hypoxemia in the patients was relieved
within 30 minutes after administration of PS, values for arterial partial
pressure of oxygen (PaO2), arterial oxygen/alveolar oxygen ratio (a/A PO2)
significantly increased, P<0.01. But the oxygenation index (OI), peak
inspiratory pressure (PIP), mean airway pressure (MAP), fraction of
inspired oxygen (FiO2) decreased significantly, P<0.01. (2) The patients
without pneumonorrhagia were released from ventilator within 36 hours of PS
administration without any sequel. Although the effect of PS decreased
beyond 48 hours after administration of PS, the clinical index and blood
gas index of the patients with pneumonorrhagia were better than that of the
previous period. After 1 month the two cases tended to become
bronchopulmonary dysplasia (BPD), and 3 months one was normal , another was
with BPD and retinopathy of
prematurity syndrome. All of
the patients were survived.
Conclusion: The PS is very effective for later respiratory
distress syndrome and pneumonorrhagia , especially for NRDS without
complications.