@article{article_571497, title={Surfactant Treatment in Late Preterm and Term Newborns; Indications and Outcomes}, journal={Türkiye Çocuk Hastalıkları Dergisi}, volume={14}, pages={200–206}, year={2020}, DOI={10.12956/tchd.571497}, author={Gökçe, İsmail Kürşad}, keywords={Mekonyum aspirasyon sendromu,Yenidoğan}, abstract={<p class="p1">Objective: Surfactant therapy (ST) has significantly reduced mortality and respiratory morbidities among preterm </p> <p class="p1">infants with respiratory distress syndrome (RDS). However, majority of late preterm and term infants with respiratory </p> <p class="p1">distress also suffer from non-RDS lung diseases. In some of these diseases, secondary surfactant deficiency may </p> <p class="p1">develop and ST can be beneficial. In this study we evaluated the indications and early outcomes of ST in late preterm </p> <p class="p1">and term infants. </p> <p class="p1">Material and Methods: We retrospectively evaluated the medical records of 135 late preterm and term infants who </p> <p class="p1">underwent ST between January 2009 and December 2012. The clinical characteristics of the patients, their diagnoses, </p> <p class="p1">number of surfactant application and time of administration, FiO <span class="s1">2 </span>requirements before and after ST (1st and 6th </p> <p class="p1">hours),duration of mechanical ventilation, and mortality rate were evaluated. </p> <p class="p1">Results: Among135 late preterm and term patients treated with ST, 78 (57.8%) were given ST due to lung disease other </p> <p class="p1">than RDS and had longer mechanical ventilator duration. In addition, ≥ 2 doses of surfactant requirement, pulmonary </p> <p class="p1">hypertension and mortality rate were found to be higher in these infants. Among patients with RDS, as expected, FiO <span class="s1">2 </span> </p> <p class="p1">requirement was found to decrease in the 1st and 6th hours after ST (0.60 to 0.50 & 0.37 and p <0.001). Sixteen </p> <p class="p1">percent of newborns with congenital pneumonia required repeated surfactant doses. The FiO <span class="s1">2 </span>requirement after ST </p> <p class="p1">was decreased in 42 patients with congenital pneumonia (0.67 to 0.65 & 0.48 and p <0.001). Sixteen patients with </p> <p class="p1">severe meconium aspiration syndrome (median FiO <span class="s1">2 </span>; 0.98) and 25 patients supporting with high frequency oscillatory </p> <p class="p1">ventilation (HFOV) support did not benefit from ST (p = 0.71 and p = 0.964). </p> <p class="p1">Conclusion: We observed that ST reduced oxygen requirement in the late preterm and term infants with RDS and </p> <p class="p1">congenital pneumonia. However, we found that ST was not beneficial in the infants who applied HFOV due to severe </p> <p class="p1">respiratory insufficiency. We think that prospective studies involving a larger number of patients are needed to determine </p> <p> </p> <p class="p1">treatment options in these patient groups. </p>}, number={3}, publisher={T.C. Sağlık Bakanlığı Ankara Şehir Hastanesi}