Surfactant treatment in premature infants with Respiratory Distress Syndrome in Curacao

Surfactant replacement therapy for Respiratory Distress Syndrome (RDS) in p remature neonates has been established as an effective treatment, although significant mortality and morbidity remain. In Curacao, surfactant became a vailable as a therapeutic option in 1994. A retrospective cohort study was performed to describe the results of surfactant treatment in premature newb orns with RDS in Curacao between 1994 and 1998. Of 429 infants admitted to the study hospital in this period, 7.5% (n=32) developed RDS and were treat ed with surfactant. Twenty-five per cent (n=8) of these infants died, most of them in the first year of surfactant treatment. Twenty-eight per cent (n =9) developed bronchopulmonary dysplasia (BPD), the most frequently observe d complication, The highest incidence of BPD (44%) was found in the very lo w birth weight infants (750-1500 g); all infants with BPD were 27-30 weeks of gestational age. The duration of ventilator dependence was significantly associated with the development of BPD (p < 0.05). No other risk factors f or complications during the treatment course could be identified. The mean time between birth and the first surfactant treatment was more than nine ho urs. In this study, we found low incidence rates of RDS and BPD, and a cons iderable mortality in surfactant treated newborns. This pilot study shows t hat surfactant treatment of premature infants is feasible in Curacao. Earli er administration of surfactant, preferably within 2-3 hours after birth, i s expected to lower the risk of death and oxygen dependence.