ABSTRACT
Objective To investigate the clinical effect of three kinds of dose of pulmonary surfactant (PS) in neonatal respiratory distress syndrome (NRDS), and to determine the optimal dose. Methods One hundred and seventy-four cases of NRDS were divided into A group (59 cases), B group (57 cases) and C group (58 cases) according random digits table. Based on the conventional treatment, children in A group were given large dose of poractant alfa injection 250 mg/kg, children in B group were given 200 mg/kg, and children in C group were given 100 mg/kg. After treatment for 1, 6, 12 and 24 h, the arterial oxygen saturation (SaO2), inspired oxygen concentration (FiO2), arterial oxygen tension (PaO2), oxygenation index (OI), arterial/alveolar oxygen tension ratio (a/APO 2), ventilator using and oxygen using time and the incidence of complication were compared. Results After treatment for 12,and 24 h, the levels of SaO 2 in A group and B group were significantly higher than those in C group: 0.936 ± 0.018, 0.935 ±0.019 vs. 0.857 ±0.027;0.941 ±0.017, 0.946 ±0.015 vs. 0.847 ±0.053, and there were significant differences (P0.05). After treatment for 1, 6, 12, and 24 h, the levels of FiO 2 and OI in A group and B group were significantly lower than those in C group, and the levels of PaO 2 and a/APO2 in A group and B group were significantly higher than those in C group. There were significant differences (P0.05). The ventilator using time in A, B and C group were (108.6±23.5) , (119.6±32.8), (156.3±27.3) h, and there were significant differences (P0.05). The oxygen using time in C group was significantly longer than that in A and B group: (186.5 ± 52.8) h vs. (148.7 ±24.4), (154.6±28.2), P0.05).The incidence of complication in C group was significantly higher than that in A and B group:29.31%(17/58) vs. 13.56%(8/59), 12.28%(7/57), P<0.05. Conclusions Poractant alfa injection 200 mg/kg is optimal dosage for poractant alfa injection in the treatment of NRDS, and it can effectively improve oxygenation and ventilation function, reduce the incidence of complication, shorten the course of disease and improve the prognosis and increase the cure rate. Excessive dose is waste, and little dose can not get effective treatment.