EFFECT OF SURFACTANT REPLACEMENT THERAPY ON THE OUTCOME OF PREMATURE-INFANTS WITH RESPIRATORY-DISTRESS SYNDROME

Lung surfactant replacement has been tested clinically in recent years . In this study the outcome of 31 premature infants with moderate to s evere neonatal respiratory distress syndrome (RDS) treated with surfac tant was compared to that of 74 prematures with RDS treated convention ally by positive pressure ventilation and supportive care. The groups were well matched for gestational age, birthweight, sex, and Apgar sco res at 1 and 5 min. Surfactant treatment resulted in a significant dec rease in mortality - from 36.6% in the untreated group to 12.9% in the surfactant-treated group (P<0.04). This improvement in survival was s een also in prematures with a birthweight <1,000 g; in the untreated g roup mortality was 57.6% compared to 23.5% in the treated group (P<0.0 5). The incidence of pneumothorax was lower in the treated group - 42% vs. 13% (P<0.01). Surfactant treatment resulted in a trend of more su rvivors without bronchopulmonary dysplasia or intraventricular hemorrh age, even though surfactant therapy did not change the incidence of ei ther.