Author/Authors :
Altuntaş, Nilgün Gazi Üniversitesi - Tıp Fakültesi - Neonatoloji Bilimdalı, Turkey , Koç, Esin Gazi Üniversitesi - Tıp Fakültesi - Neonatoloji Bilimdalı, Turkey , Türkyılmaz, Canan Gazi Üniversitesi - Tıp Fakültesi - Neonatoloji Bilimdalı, Turkey , Kulalı, Ferit Gazi Üniversitesi - Tıp Fakültesi - Neonatoloji Bilimdalı, Turkey , Beken, Serdar Gazi Üniversitesi - Tıp Fakültesi - Neonatoloji Bilimdalı, Turkey , Önal, Esra Gazi Üniversitesi - Tıp Fakültesi - Neonatoloji Bilimdalı, Turkey , Ergenekon, Ebru Gazi Üniversitesi - Tıp Fakültesi - Neonatoloji Bilimdalı, Turkey , Atalay, Yıldız Gazi Üniversitesi - Tıp Fakültesi - Neonatoloji Bilimdalı, Turkey
Abstract :
Purpose:Although recent randomized and controlled trials have demonstrated that prophylactic or early surfactant administrations have better outcomes in high risk preterm infants compared to delayed or rescue surfactant treatment, there is no definitive answer for the question of best timing of surfactant application at different gestational ages. In this retrospective study, our goal is to retrospectively determine the effect of delivery room surfactant treatment on pneumothorax, intraventricular bleeding (IVK), patent ductus arteriosus (PDA), chronic lung disease (CLD), necrotizing enterocolitis (NEC), mortality and the duration of mechanical ventilation and hospitalization of each patient. Materials and methods:Preterm infants with a gestational age of 28 weeks and below who received surfactant between January 2006 and December 2010 were included in this study. Preterm infants were placed into either a prophylactic group (infants who received surfactant within fifteen minutes after birth) or selective group (infants who received surfactant therapy for established RDS) the groups were determined according to the time of surfactant replacement therapy. Results: There were 24 and 46 patients in the prophylactic and selective group respectively. Although the number of patients with pneumothorax was significantly lower in the prophylactic group (p=0.02), there was no significant difference between the two groups for IVK, PDA, CLD, NEC, the duration of mechanical ventilation and hospitalization and mortality rates. Conclusion: The prophylactic administration of surfactant decreased the incidence of pneumothorax significantly. However, there was no significant difference in mortality rates and neonatal outcomes between the two groups. We need further studies to determine the best timing of surfactant replacement.
