Clinical effect of minimally invasive surfactant therapy in the treatment of neonatal respiratory distress syndrome / 中国基层医药

ABSTRACT

Objective:To explore the feasibility and safety of minimally invasive surfactant therapy(MIST) in the treatment of neonatal respiratory distress syndrome(RDS).Methods:A total of 93 preterm infants with gestational age of 32-36 weeks admitted from April 2017 to April 2019 were eligible to receive exogenous pulmonary surfactant(PS) with diagnosis as RDS.According to the random digital table method, they were randomly divided into two groups MIST group( n=48) and intubation-surfactant-extubation(INSURE) treatment group( n=45). During nasal continuous positive airway pressure(NCPAP) ventilation, PS with thin catheter and trachea intubation were chosen, the curative effects of the two groups were compared. Results:All infants received PS successfully, the heart rate, breath rate and fraction of inspiratory oxygen(FiO 2) after treatment of the two groups were significantly lower than those before treatment, and the differences were statistically significant ( t=7.739, 6.497, 7.450, 3.992, 3.787, 4.343, all P<0.05). However, there were no statistically significant differences in heart rate, breath rate and FiO 2 between the two groups whenever before or after administration(all P>0.05). There were also no statistically significant differences in the rate of mechanical ventilation within 72 hours after birth, the time of mechanical ventilation and NCPAP, the time of oxygen inhaling and hospital stays, and the rate of pneumothorax between the two groups(all P>0.05). The incidence of drug reflux in the MIST group [20.8%(10/48)] was higher than that in the INSURE group [8.3%(4/45)](χ 2=3.876, P<0.05), but the incidences of bradycardia, transcutaneous oxygen saturation decreased(<85%) and the secondary administration had no statistically significant difference between the two groups( P>0.05). Conclusion:MIST is effective in the treatment of RDS in moderately preterm infants, but it presents not too much benefits of effectiveness and complications, as well as the disadvantage of drug reflux, thus whether it is better choice for surfanctant procedure needs more studies.