Yenidoğanlarda respiratuvar distres sendromu dışı sürfaktan tedavisi

Abstract

Bir fosfolipid karışımı olan sürfaktan, yüzey gerilimini azaltır ve alveolleri açık tutar. Eksikliğinde yaygın atelektazi gelişir ve bunun sonucunda ventilasyon perfüzyon dengesi ve gaz değişimi bozulur. Sürfaktan akciğer tip II alveolar hücrelerinde yapılmakta ve asıl olarak prematüre bebeklerin hastalığı olan respiratuvar distres sendromu (RDS) tedavisinde intratrakeal olarak kullanılmaktadır. Ancak, son zamanlarda özellikle de geç preterm ve term bebeklerde sekonder sürfaktan yetersizliğine bağlı gelişen; infeksiyon (pnömoni), aspirasyon (mekonyum) ve konjenital pulmoner malformasyon (diyafragma hernisi) gibi bazı hastalıklarda da eksojen sürfaktan kullanımı ve potansiyel faydaları üzerinde durulmaya başlanılmıştır. Bu derlemede yenidoğan bebeklerde akciğerde sekonder sürfaktan yetersizliğine yol açan RDS dışı hastalıklarda sürfaktan kullanımı ve etkinliği ile yan etkileri güncel literatür verileri ve rehberler eşliğinde tartışılmış ve bilimsel öneriler sunulmuştur.

Keywords

• Yenidoğan
• sürfaktan
• tedavi

Surfactant treatment in newborns other than respiratory distress syndrome

Abstract

Surfactant, a phospholipid mixture, reduces surface tension and keeps the alveoli open. In its deficiency, widespread atelectasis develops, and, as a result, ventilation perfusion balance and gas exchange are impaired. Surfactant is produced in lung type II alveolar cells and is mainly used intratracheally in the treatment of respiratory distress syndrome (RDS), a disease of premature babies. However, recently, the use of exogenous surfactant and its potential benefits have also begun to be emphasized in some diseases such as infection (pneumonia), aspiration (meconium), and congenital pulmonary malformation (diaphragmatic hernia) that develop due to secondary surfactant insufficiency, especially in late premature and term babies. In this review, the use of surfactant in non-RDS diseases that cause secondary surfactant deficiency in the lungs in newborn babies, its effectiveness and side effects are discussed with current literature data and guidelines, and scientific recommendations are presented.

Keywords

• Newborn
• surfactant
• therapy

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