Retrospective analysis for 168 cases of neonates respiratory distress syndrome treated by Curosurf combined with different mechanical ventilation mothods

Objective To summarize our experience in the treatment of respiratory distress syndrome (RDS) in neonates by. Calsurf combined with mechanical ventilation (MV). Methods The study involved RDS patients who admitted to neonatal intensive care unit (NICU) and received Curosurf and MV treatment. The data were retrospectively collected from the patients'cases in a standard form,which included general clinical characteristics,mechanical ventilation modes,complications,outcome,and so on. The therapeutic effect of Calsurf was evaluated,and blood gas and ventilator settings were recorded at 0,1,12,72 hours after treatment with Curosurf. Results (1)Mean (SD) gestational age (GA) of the neonates was (32.3±3.7) weeks,and 88.7% of them was preterm (GA 37 weeks). Mean birth weight (BW) was (1 730±750) grams,and 87.5% of them had BW 2 500 grams. The male/female ratio was 4.6∶1(138/30). (2)At 0,1,12 and 72 hours after treatment with Calsurf,FiO2 of RDS patients was 0.51±0.11,0.32±0.1,0.28±0.08 and 0.26±0.09,respectively. There was a significant decrease in FiO2,however,there was a increase in PiO2/FiO2 and a/APO2,which were observed at different time points,especially between 0 and 1 hour (P0.05). (3)Different ventilation modes were applied to these patients. In 14.9% (25/168) of these infants,surfactant was administered during a brief intubation followed by immediate extubation (Intubation sur factant extubation). The surfactant therapy was successfully given only during NCPAP without intubation ventilation in these infants. The conventional mechanical ventilation (CMV),high frequency oscillation ventilation (HFOV) and CMV+HFOV were 77.7%,7.0% and 2.1% respectively in the other 143 infants. (4)The two main complications were ventilation related pneumonia and pneumothorax. The total mortality in hospital was 10.7%. Conclusion The Calsurf can quickly improve oxygenation status in patients with RDS. The clinicians are using more and more new therapy methods to rescue RDS patients. These data provide possibility for future studies in the improvement of respiratory care in Tertiary level NICUs.