E. Murdoch et St. Kempley, The effects of synthetic and natural surfactant on fluid balance in acute respiratory distress syndrome, EUR J PED, 159(10), 2000, pp. 767-769
To evaluate the effect of different surfactants on fluid balance in respira
tory distress syndrome, we studied 24 premature infants who were randomised
to receive either natural or synthetic surfactant. Data were collected on
ventilatory parameters, daily urine output, daily weight, fluid intake and
serum electrolytes. Ventilatory requirements decreased more rapidly in babi
es receiving natural surfactant, with significantly greater reductions in m
ean airway pressure from 1 to 48 h and oxygenation index from 1-18 h (P < 0
.05). There were no differences in fluid intake and serum electrolytes. Mea
n daily urine output was higher in the group receiving natural surfactant (
87 ml versus 61 ml, P < 0.05). This group also had a greater weight loss fr
om birth weight (-146 g versus -65 g, P < 0.05).
Conclusion Natural surfactant produces an earlier reduction in ventilatory
requirements with an earlier diuresis. This should influence fluid manageme
nt in respiratory distress syndrome.