SURFACTANT THERAPY IN RESPIRATORY-DISTRESS SYNDROME - THE EFFECT OF ALEARNING-CURVE IN IMPROVING OUTCOME

A retrospective study of all premature neonates who received artificia l surfactant (Curosurf) at the Rotunda Hospital was performed. The per iod from October 1990 to June 1992 (n=48) was compared with the initia l experience from June 1987 to January 1988 (n=15). In the initial per iod mortality rate was 67% in surfactant treated infants, and use of s urfactant was not associated with an improvement in outcome compared w ith the previous six years. In the more recent period overall mortalit y was 21%. Overall survival in normally formed very low birthweight in fants improved from 59% in 1986 to 86% in 1991-1992. Improvement in su rvival rates was most noticeable in infants with birthweight 750-999 g rams, with survival increasing from 44% (before introduction of surfac tant treatment) to 91% (in 1991-1992). It is probable that a certain l evel of experience with use of surfactant is required before optimal e ffects can be obtained.