Reyna-Ríos ER, Fernández-Carrocera LA, Salinas-Ramírez V, Echaniz-Avilés O, Romero-Maldonado S

Language: Spanish
References: 19
Page: 219-223
PDF size: 119.52 Kb.

ABSTRACT

Introduction: Respiratory distress syndrome (RDS) is the principal respiratory problem in premature infants with high morbidity and mortality, due to immaturity and lack of production of pulmonary surfactant. Objective: Establish differences (incidence of RDS, intraventricular hemorrhage, broncopulmonar dysplasia, ventilation time and death) in the profilactic treatment between two types of natural surfactant (porcine and bovine) in preterm infants. Material and methods: Cross sectional, retrospective and analytic study from July 2005 to July 2006. The inclusion criteria were: birth weight between 600- 1250 g, gestational age less than 32 weeks, orotraqueal intubation and hemodynamic stability, included in two groups: group 1 (poractant alfa 200 mg/kg/doses) and group 2 (beractant 100 mg/kg/doses). Birthweight, gestational age, FiO₂, ventilation time, RDS, BPD, intraventricular hemorrhage, ROP and mortality were analysed. Statistical analysis was done with SPSS 15, using, depending the type of variable, chi cuadrada, t de Student, U de Mann-Whitney and OR (CI 95%). Results: In the poractant alfa group there were 74 cases, and beractant group 80. The requirement of FiO₂, ventilation time, cases of RDS, DBP, ROP, and the association of RDS with mortality were less for poractant alfa group, and they only received one dosis in the 83% of the cases. These differences were statistical significant. Conclusions: The use of poractant alfa reduces the risk of developing RDS, the percentage of FiO₂ required, hours of mechanical ventilation and BPD, as well as the need for further doses.

REFERENCES

1. Couser RJ, Ferrara TB, Ebert J, Hoekstra RE, Fangman JJ. Effects of exogenous surfactant therapy on dynamic compliance during mechanical breathing in preterm infants with hyaline membrane disease. J Pediatr 1990; 116: 119-24.

2. Obladen M. History of Surfactant up to 1980. Biol Neonate 2005; 87: 308-16.

3. Whitsett JA, Weaver TE. Hydrophobic surfactant proteins in lung function and disease. N Engl J Med 2002; 347: 2141-8.

4. Mercier CE, Soll RF. Clinical trials of natural surfactant extract in respiratory distress syndrome. Clin Perinatol 1993; 20: 711–35.

5. Dunn M, Shennan A, Possmayer F. Bovine surfactant replacement therapy in neonates of less than 30 weeks’ gestation: A randomized controlled trial of prophylaxis versus treatment. Pediatrics 1991; 87: 377-86.

6. Enhorning G, Shennan A, Possmayer F et al. Prevention of neonatal respiratory distress syndrome by tracheal instillation of surfactant: a randomized clinical trial. Pediatrics 1985; 76: 145-53.

7. Soll RF. Prophylactic natural surfactant extract for preventing morbility and mortality in preterm infants. Cochrane Library 2004 Nov (cited 2006); 1:27. Available from http//gateway.ut.ovid.com.

8. Ambalavanan N, Carlo AW. Hipocapnia e hipercapnia en la atención respiratoria del recién nacido. Clin Perinatol 2001; 3: 517-31.

9. Ho JJ, Henderson-Smart DJ, Davis PG. Early versus delayed initiation of continuous distending pressure for respiratory distress syndrome in preterm infants. [Systematic Review] Cochrane Neonatal Group Cochrane Database of Systematic Reviews 1, 2006.

10. Bevilacqua G, Parmigiani S, Robertson B and the Italian Collaborative Multicentre Study Group. Prophylaxis of respiratory distress syndrome by treatment with modified porcine surfactant at birth: a multicentre prospective randomized trial. J Perinat Med 1996; 24: 1-12.

11. Bevilacqua G, Chernev T, Parmigiani S et al. Use of surfactant for prophylaxis versus rescue treatment of respiratory distress syndrome: experience from an Italian-Bulgarian trial. Acta Biomed Ateneo Parmense 1997; 68: 47-54.

12. Egberts J, DeWinter JP, Sedin G 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.

13. Merritt TA, Hallman M, Berry C, Pohjavuori M, Edwards DK et al. Randomized, placebo-controlled trial of human surfactant given at birth vs rescue administration in very low birthweight infants with lung immaturity. J Pediatrics 1991; 118: 581-94.

14. Walti H, Paris-Llado J, Breart G, Couchard M, and the French Collaborative Multicentre Study Group. Porcine surfactant replacement therapy in newborns of 25-31 weeks’ gestation: a randomized multicentre trial of prophylaxis versus rescue with multiple low doses. Acta Paediatr 1995; 84: 913-21.

15. Ramanathan R. A randomized multicenter masked comparison trial of poractant alfa (courosurf) vs berectant (survanta) in the treatment of respiratory distress syndrome in preterm infants. Am J Perinatol 2004; 21: 109-19.

16. Fortes F, Eckert G, Tartella MB, Procianoy RS. Prevention of retinopathy of prematurity. Arq Bras Oftalmol 2011; 74: 217-21.

17. Kermorvant-Duchemin E, Sennlaub F, Behar-Cohen F, Chemtob S. Épidémiologie et physiopathologie de la rétinopathie du premature. Arch Pediatr 2011; 18: S79-S85.

18. Coalson J. Pathology of new bronchopulmonary dysplasia. Semin Neonatol 2003; 8: 73-81.

19. Simonato M, Baritussio A et al. Disaturated-phosphatidylcholine and surfactant protein-B turnover in human acute lung injury and in control patients. Respir Res 2011; 24: 12-36.