Browse > Article

A Study on the Effects of Early Surfactant Replacement and Gentle Ventilation in the Treatment of Respiratory Distress Syndrome  

Lee, Yong Suk (Department of Pediatrics, Fatima Hospital)
Lee, Ji Hye (Department of Pediatrics, Fatima Hospital)
Lee, Sang Geel (Department of Pediatrics, Fatima Hospital)
Publication Information
Clinical and Experimental Pediatrics / v.48, no.10, 2005 , pp. 1096-1101 More about this Journal
Abstract
Purpose : Recently, early surfactant replacement and tidal volume based gentle ventilation has been a fundamental treatment of respiratory distress syndrome(RDS). The aims of this study were to survey the changes in ventilator care duration and rate of complication in RDS groups. Methods : We performed a retrospective study of 255 newborn infants less than 1,500 g admitted to the neonatal intensive care unit(NICU) and discharged from January 1999 to December 2003. 141 of 255 newborn infants were RDS groups that required invasive management, such as endotracheal intubation, surfactant replacement and assisted ventilation. We analyzed epidemiologic data to study the changes in ventilator care duration and outcome of RDS groups. Results : Of 141 RDS groups, 135 were mild to moderate RDS groups and only 6 were severe RDS groups. 24(17.8%) of 135 mild to moderate RDS groups and 3(50%) of 6 severe RDS groups were antenatal no use of maternal dexamethasone. 127(90.1%) of 141 RDS groups underwent replacement of surfactant during 3 hours after birth. 121(85.9%) weaned within 48 hours. Conclusion : Our study shows a decreased frequency of severe RDS by a antenatal use of maternal dexamethasone and decreased duration of ventilator care by early surfactant replacement and gentle ventilation.
Keywords
Respiratory distress syndrome; Surfactant; Gentle ventilation; Dexamethasone;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Lorenz JM. RDS, surfactant therapy. In : Wung JT, editor. Respiratory care of the newborn : a practical approach. 15th ed. New York : Children's hospital of NewYork-Presbyterian, 2003:161-184
2 Gonzalo LM, Waldemar AC. Ventilatory management in neonates. Clin Perinatol 1998;25:33-48
3 Null DM. High frequency ventilation. In : Wung JT, editor. Respiratory care of the newborn : a practical approach. 15th ed. New York : Children's hospital of New York-Presbyterian, 2003:95-108
4 Baek JY, Kim JH, Park KA, Kang SH, Hur MH, Lee SG. A study on the effect of the combined use of gentle ventilatior and high-frequency ventilator on the incidence of chronic lung disease. J Korean Pediatr Soc 2000;43:1544-51
5 Gitterman MK, Fusch C, Gitterman AR, Regazzoni BM, Moessinger AC. Early nasal continuous positive airway pressure treatment reduces the need for intubation in very low birth weight infants. Eur J Pediatr 1997;156:384-64   DOI   ScienceOn
6 Verder H, Robertson B, Greisen G, Ebbesen F, Albertsen P, Lundstorm K, et al. Surfactant therapy and nasal continuous positive airway pressure for newborns with respiratory distress syndrome. N Engl J Med 1994;331:1051-5   DOI   ScienceOn
7 Jung BK, Kim YJ, Lee SG. A study on the changes in ventilator care rate and outcome of very low birth weight infants during last four years. J Korean Pediatr Soc 2003;46:1073-79
8 Kim YJ, Jung BK, Lee SG. A study on the effects of the early use of nasal CPAP in the weaning of mechanical ventilators. J Korean Pediatr Soc 2003;46:1200-6
9 Kim EJ, Kim HS, Hur MH, Lee SG. Effect of nasal continuous positive airway pressure after early surfactant therapy in moderate respiratory distress syndrome. J Korean Pediatr Soc 2002;45:1204-12
10 Joshi VV, Mandavia SG, Stern L, Wigglesworth FW. Acute lesion induced by endotracheal intubation. Am J Dis Child 1972;124:646-9
11 Thompson MA. Early nasal CPAP and surfactant trial. Hot Topics 2001 in neonatology; 2001 Dec 9-11; Washington, DC, Ross Special Conference 2001:202-11
12 Bomsel F. Radiologic study of hyaline membrane disease : 110 cases. J Radiologic Electrol 1970;51:259-68
13 Ha SJ, Ryu DK, Lee OK, Kim WS. Diagnostic value and relationship of the between stable microbubble rating test and shake test for the prediction of neonatal respiratory distress syndrome. J Korean Pediatr Soc 1994;37:620-7
14 Hur MH, Kim YG, Baek JY, Lee SG. Clinical effect and complication of high frequency ventilation on respiratory failure. J Korean Pediatr Soc 1999;42:164-72
15 Jobe AH. Pulmonary surfactant therapy. N Engl J Med 1993;328:861-8   DOI   ScienceOn
16 Parker JC, Hernendez LA, Peevy KJ. Mechanisms of ventilatior induced lung injury. Crit Care Med 1993;21:131-43   DOI   ScienceOn
17 Kendig JW, Notter RH, Cox C, Reubens LJ, Davis JM, Maniscalco WM, et al. A comparison of surfactant as immediate prophylaxis and rescue therapy in newborns of less than 30 weeks' gestation. N Engl J Med 1991;324:865-71   DOI   ScienceOn
18 Kamper J, Wulff K, Larsen C, Lindequist S. Early treatment with nasal continuous positive airway pressure in very low birth weight infants. Acta Paediatr 1993;82:193-7   DOI   ScienceOn
19 Suresh GK, Soll RF. Current surfactant use in premature infants. Clin Perinatol 2001;28:671-94   DOI   ScienceOn
20 Wung JT, Leaderstorf MR. CPAP therapy. In : Wung JT, editor. Respiratory care of the newborn : a practical approach. 15th ed. New York : Children's hospital of New York-Presbyterian, 2003:33-56
21 Alba J, Agarwal R, Hegyi T, Hiatt IM. Efficacy of surfactant therapy in infants managed with CPAP. Pediatric Pulmonol 1995;20:172-6   DOI   ScienceOn
22 Hallman M, Merrit TA, Jarvenpaa AL, Boynton B, Mannino F, Gluck L, et al. Exogenous human surfactant for treatment of severe respiratory distress syndrome : a randomized prospective clinical trial. J Pediatr 1985;106:963-9   DOI   PUBMED
23 Fujiwara T, Maeta H, Chida S, Morita T, Watabe Y, Abe T, et al. Artificial surfactant therapy in hyaline membrane disease. Lancet 1980;1:55-9
24 Wauer RR. Respiratory distress syndrome. In : Wauer RR, editor. Surfactant therapy. 1st ed. Stuttgatt : Georg Thieme Verlag 1998:2-20
25 Egberts J, Winter JP, Sedin G, Kleine MJ, Broberger U, Bel F, et al. Comparison of prophylaxis and rescue treatment with Curosurf in neonates less than 30 weeks' gestation : a randomized trial. Pediatrics 1993;92:768-74
26 Avery ME, Mead J. Surface properties in relation to atelectasis and hyaline membrane disease. Am J Dis Child 1959;97:517-23
27 Pramanik AK, Holtzman RB, Merrit TA. Surfactant replacement therapy for pulmonary disease. Pediatr Clin N Am 1993;40:913-36
28 Wung JT. Mechanical ventilation using conventional infant ventilators. In : Wung JT, editor. Respiratory care of the newborn : a practical approach. 15th ed. New York : Children's hospital of NewYork-Presbyterian, 2003:69-94