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Surfactant Replacement Therapy for RDS: a Collaborative Study of 72 Multi-center Trials in Korea (2010) and a Review of Korean Experiences over 20 Years

2010년 전국 72개 병원에서 신생아 호흡곤란증후군의 폐 표면활성제 치료 결과: 지난 20년간의 비교

  • Bae, Chong-Woo (Department of Pediatrics, Kyung Hee University School of Medicine) ;
  • Hahn, Won-Ho (Department of Pediatrics, Kyung Hee University School of Medicine) ;
  • Chang, Ji-Young (Department of Pediatrics, Kyung Hee University School of Medicine) ;
  • Kim, Sung-Mi (Department of Pediatrics, Busan St. Mary's Medical Center)
  • 배종우 (경희대학교 의학전문대학원 소아청소년과) ;
  • 한원호 (경희대학교 의학전문대학원 소아청소년과) ;
  • 장지영 (경희대학교 의학전문대학원 소아청소년과) ;
  • 김성미 (부산성모병원 소아청소년과)
  • Published : 2011.11.30

Abstract

In Korea, pulmonary surfactant (PS) replacement therapy in respiratory distress syndrome (RDS) was started in 1991 since when Surfacten$^{(R)}$ was imported from Japan. At the present time, Surfacten$^{(R)}$, Newfactan$^{(R)}$, Curosurf$^{(R)}$, and Infasurf$^{(R)}$ are available in Korea. The governmental health insurance covers the expense for multiple dose treatment since 2002 and the early prophylactic treatment (BW: <1,250 g or GP: <30 wks) since 2011. We undertook a multi-institutional collective study to evaluate the outcomes of PS over past 20 years in Korea (Period-I; 1990/91, P-II; 1996, P-III; 2002, and P-IV; 2007, P-V; 2010). There were 60 RDS neonates with PS treatment in P-I (16 hospitals), 1,179 in P-II (64), 1,595 in P-III (62), 1,921 in P-IV (57), and 3,160 in P-V (72). Decreased mortality rate, defined as the percentage of neonates who died within 28 days of birth, was seen between periods, P-V vs P-I, II, III, and IV (mortality rate: 10.1% vs. 40.0%, 30.0%, 18.7%, and 14.3%). We conclude that PS therapy contributed to improve remarkable outcome in RDS neonates over the last 20 years in Korea. However, more efforts should be made to optimize PS therapy for better outcome. Multiple PS doses for relapse and poor response, early prophylactic use, and better supportive care for pre-term infants are mandatory.

Keywords

References

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