Effects of High Frequency Ventilation after Surfactant Replacement Therapy Compared with Conventional Ventilation in the Neonatal Respiratory Distress Syndrome

ABSTRACT

PURPOSE: We performed a retrospective study to compare effects of Surfacten(R) with HFV administration and meticulous conventional ventilatory support for neonatal RDS by analyzing clinical effects, complication and mortality between two groups. METHODS: Of 107 cases admitted to the nursery in Taegu Fatima hospital from February 1990 to June 1996, 52 neonates (admitted from January 1993 till June 1996) with RDS on high frequency ventilation after Surfacten(R) replacement were included as study group while 57 neonates(admitted from January 1990 till December 1996) with RDS on only conventional ventilation as control group. Serial change of FiO2, MAP, PaO2 and PaCO2 within 48hours after Surfacten(R) replacement, chest X-ray, clinical course, complication and mortality rate were propectively analyzed between two groups. RESULT: 1) After 24 hours Surfacten(R) replacement FiO2 had gradually decreased to 40% in the treated group, while in the control group, decreased to 50% within 48 hours. 2) MAP was maintained at 5.2cmH2O in the treated group, while in the control group, at 6.9cmH2O. 3) Serial change of PaO2 during weaning period after Surfacten(R) replacement between two groups were not significantly different(in the treated group 74.5mmHg, in the conrol group 76.1mmHg). 4) Serial change of PaCO2 during weaning period after Surfacten(R) replacement in the treated group were maintained significantly below the level of PaCO2 in the control group(in the treated group 42.3mmHg, in the control group 46.6mmHg). 5) In the treated group, complications were a series of PDA, IVH and pneumothorax, while in the control group, of PDA, Sepsis and IVH, and there were no differences between two groups with respect to mortality. CONCLUSION: It was concluded that the combined treatment with Surfacten(R) replacement and high frequency ventilation for neonatal RDS improved short term clinical effects than in the control group, but there were no significant difference in terms of complications and mortality rate between two groups