Outcome of Very Premature Newborn Receiving an Early Second Dose of Surfactant for Persistent Respiratory Distress Syndrome
Résumé
Background: Infants presenting respiratory distress syndrome (RDS) not responding to
surfactant often receive a second instillation. Few studies evaluated the consequences
of this second administration. This study aimed at determining the outcome of infants
presenting persistent RDS and receiving an early second dose of surfactant.
Methods: Infants below 32 weeks’ gestation who received a second dose of 100mg/kg
of surfactant within the first 72 h of life, were retrospectively involved in this 42 months’
study. They were matched to two controls receiving a single dose of 200mg/Kg based
upon gender and gestational age.
Results: 52/156 infants receiving two doses (Group 2-doses) were significantly more
often SGA [22 (42%) vs. 21 (20%) p = 0.04] and outborn [29 (56%) vs. 13 (12%)
p = 0.001]. They had received antenatal corticos teroid therapy less often [26 (50%)
vs. 89 (86%) p = 0.001] and presented more severe RDS based upon FiO2 level,
oxygenation index and radiography. Group 2-doses survival was lower (65.4% vs. 79.6
% p < 0.1) but surviving infants did not have different morbidity than controls.
Discussion: Premature newborn receiving a second dose of surfactant had adverse
antenatal characteristics, presented more severe RDS and only partially responded to
the first dose. Outcomes of surviving infants who received 2 doses of surfactant were
comparable to others.
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