Single versus multiple doses of surfactant treatment in preterm infants

INTRODUCTION: Exogenous surfactant may be needed not only for respiratory distress syndrome treatment; but also in the management of other pulmonary diseases of infants. In this study we aimed to investigate the impact of single versus multiple doses of surfactant therapy in pulmonary problems of preterm infants.
METHODS: In this study, preterm infants who needed surfactant treatment were retrospectively evaluated. Surfactant therapy for respiratory distress syndrome were given as 200mg/kg poractant or 100mg/kg beractant and repeated with 100mg/kg doses when needed later. Poractant or beractant (100mg/kg) were given in the treatment of other pulmonary diseases.
RESULTS: Totally 64 preterm patients were recruited in the study. Patients in the Group 1 (43.8%) received single dose of surfactant; whereas Group 2 patients (56.2%) had more than one dose. Mean gestational age and birth weight of infants in Group 2 were significantly lower than Group 1 (p<0.05). Intrauterine growth restriction was more common in Group 2 (p=0.041). Multiple doses of surfactant were needed for severe respiratory distress syndrome, atelectasis, pulmonary hemorrhage and pneumonia. Duration of mechanical ventilation and hospitalization were longer in Group 2 (p<0.05). Mortality rates were higher in Group 2 (p=0.011).
DISCUSSION AND CONCLUSION: Preterm infants with earlier gestational age and lower birth weight; particularly with intrauterine growth restriction may need multiple doses of surfactant due to more severe respiratory problems regardless of antenatal steroid or maternal chorioamnionitis status. Duration of mechanical ventilation, hospitalization and also neonatal mortality remained higher due to disease severity in preterms who needed multiple doses of surfactant.