Evaluation of results in neonatal respiratory distress syndrome

ABSTRACT EVALUATION OF RESULTS IN NEONATAL RESPIRATORY DISTRESS SYNDROME Surfactant is usually given to mechanically ventilated preterm infant via an endotracheal tube to treat respiratory distress syndrome. Even if this approach is life saving method, mechanical ventilation and entubation are risk factors for mortality and morbidity. This study was conducted to evaluate and compare the effectiveness of new developed minimal invasive methods of surfactant administration (thin catheter method by using magill forceps, INSURE) The research has been performed on spontaneously breathing infants, whose gestational age was >24 and <34 weeks and since May 2013. The research was conducted on 15 patients between 685-2100 gr weights, needed surfactant administration. Poractant alpha, dosed 200 mg/kg was administered to the patients on spontaneous breathing with continuous positive airway pressure support. 7 of 15 patients were administrated surfactant by using thin cathater whereas 8 of them were recieved by INSURE method. The groups were defined randomly. The data, regarding the delivery method, birth weight, gender, prenatal history, usage of steroids, APGAR scores and the other data, obtained from the patients until hospital discharge, were recorded. Desaturation and bradycardia for 3-4 minutes were observed in %71 (5/7) of MIST and %87,5 (7/8) of INSURE ones. Bradycardia was observed in 4 of 8 patients from INSURE group and positive ventilation was needed. From INSURE group, 3 patients dead; one of 15 had ROP and this patient was from INSURE group. No difference was found among groups, regarding O2 required duration and days of hospital stay (p<0,05). The thin catheter group had significantlly fewer median days on mechanical ventilation and lower rate of mortality (p<0.05). As a result; when there was no need for mechanic ventilation, intubation for surfactant administration was determined not to be necessary, in the present study. The thin catheter method was observed to be the best way for surfactant administration among the methods without intubation. Key Word: Respiratory distress syndrome, surfactant, complication, new method, CPAP