Endotracheal administration of surfactant in very low birth weight infants with respiratory distress syndrome.

摘要: This study was designed to evaluate whether the ventilatory maneuvers associated with surfactant replacement would, per se, influence oxygenation in newborn infants severe respiratory distress syndrome. Eight patients (700 1400 g), all requiring mechanical ventilation fraction of inspired oxygen greater than 0.6, were included trial; four randomized receive surfactant, and others served as controls. Porcine (2 ml/kg; phospholipid concentration, 100 mg/ml) instilled via a naso-endotracheal tube at end-expiration dispersed into lungs during period standardized "sighing" mediated by ventilator: two prolonged cycles (10 sec each) an inspiration/expiration ratio 4:1, followed 6-min frequency 60 breath/min 4:1. Control babies received no but otherwise subjected same maneuvers. Surfactant-treated showed rapid increase transcutaneous improved lung aeration chest x-rays; response transient three persistent one. No improvement observed control babies. We conclude that beneficial effect cannot be attributed instillation procedure.