Objective To observe the effect of
pulmonary surfactant(PS) on
lung function and
ventilator parameters of
neonatal respiratory distress syndrome(NRDS) in the advanced stage.
Methods Twenty-eight
infants with NRDS were given PS in one
dose by
endotracheal intubation on the left side,right side,
feet high with
head low,and level decub respectively.The
dose of PS was 100-150 mg/kg each
time,each
posture slow note of the
drug were required 1/4,out of the straw,
hand-controlled
ventilation,to reduce fluid loss,with the exception of a clear
airway obstruction,within 6 hours after the
administration not to shoot
back suction,to give
mechanical ventilation after the
injection.
Lung function
parameters were also measured
pressure of
oxygen in
artery[p_a(O_2)],
carbon dioxide partial pressure[p_a(CO_2)],the ratio of
pressure of
oxygen in
artery and alveolar
oxygen partial pressure[a/Ap(O_2)] and
oxygenation index(OI) were determined.
Ventilator parameters were determined
oxygen concentration(FiO_2),
oxygen peak(PIP),end-expiratory positive
pressure(PEEP) and mean
airway pressure(MAP) were determined.These numerical data were analyzed and compared before and
after treatment with PS.Clinical manifestations,thoracic
X-ray changes,
survival rate and
incidence rate of
complications were also analyzed and compared before and after PS
therapy.Results p_a(O_2),a/Ap(O_2) showed significant upgrade and OI had a decrease after PS
administration in comparison with those before PS
therapy.The
ventilator parameters(except for PEEP) acquired were also lower after
drug administration than those in before
drug therapy.There were significant differences in both stages(P_a90%,
respiratory sound in 24 cases enhanced,the
observation of
chest film after 24 h indicated that,lesions in 21 cases improved significantly,5 cases took a favorable turn.The
survival rate was 85.7%.The
incidence rate of complication was as follows
pneumonia was 25%,
patent ductus arteriosus was 10.7%,pneumorrhagia was 7.1% and intraventricular
hemorrhage was 3.6%,respectively.Conclusion Respiratory function of NRDS is significantly improved by using PS in the advanced stage,and
therapeutic effect is apparent.