[Evaluation of mortalitiy rate and complications of neonatal respiratory distress syndrome treated with mechanical ventilation and surfactant therapy]

ABSTRACT

Since the first successful report of endotracheal surfactant administration in 10 neonates with RDS in 1980 by Fujiwara, several studies have shown that surfactant administration would decrease neonatal mortality and morbidity such as Pulmonary Air leak [PAL] or Brochopulmonary dysplasia [BPD]. This study was conducted in NICU of Mahdieh hospital between March 2002 and March 2005 to evaluate the mortalitiy rate and complications of neonates with RDS who have recieved mechanical ventilation and surfactant. Between March 2002 and March 2005, 124 neonates [36% females and 64% Males] with RDS, admitted in NICU were enrolled in this study. 25% of the patients were fullterm and 75% were preterm. All of them underwent mechanical ventilation due to either O2 requirement of more than 60% [through Hood] or arterial PH of less than 7.25. Surfactant was administered as 4 cc/kg per dose [Maximum 2 doses] if mean Air way pressure [MAP] was equal or more than 7 cmH[2o] or fiO[2] equal or more than 40%. Neonatal Mortality Rate [NMR] in these 124 patients was 27%. PAL was noted in 23.3% and BPD in 12.9% of cases. This study showed that with administration of surfactant the incidence of NMR was the same as several previous studies, albeit BPD incidence was lower and the incidence of PAL was higher than that of recent studies. Higher incidence of PAL may be due to late low dose surfactant administration or the quality of medical and nursing care, which must be impressed. The lower incidence of BPD in our study may be resulted from preliminary administration of prenatal dexamethasone