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Critical Care Research and Practice
Volume 2010, Article ID 235894, 5 pages
http://dx.doi.org/10.1155/2010/235894
Clinical Study

Prophylactic Administration of Surfactant in Extremely Premature Infants

Division of Neonatology, Department of Pediatrics, University of Heidelberg Medical School, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany

Received 26 August 2009; Revised 21 January 2010; Accepted 24 March 2010

Academic Editor: Ira Cheifetz

Copyright © 2010 Lutz Koch et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To investigate whether prophylactic surfactant administration is superior over selective treatment in preterm infants with respiratory distress syndrome (RDS). Methods. In our retrospective analysis, we compared premature infants (23 + 0 to 26 + 6 weeks) receiving 200 mg/kg surfactant (curosurf 0 𝑥 0 0 0 𝑎 𝑒 ) within five minutes after birth (prophylactic group, 𝑁 = 3 1 ) with those infants who received surfactant therapy for established RDS (selective group, 𝑁 = 3 4 ). Results. Prophylactic therapy significantly decreased the need for mechanical ventilation (74 hours per patient versus 171 hours per patient, resp.). We observed a reduced incidence of interstitial emphysema (0% versus 9%, resp.), pneumothoraces (3% versus 9%, resp.), chronic lung disease (26% versus 38%, resp.), and surfactant doses per patient (1.3 versus 1.8, resp.), although those variables did not reach significance. Conclusion. We conclude that infants under 27 weeks' gestation profit from prophylactic surfactant administration by reducing the time of mechanical ventilation. This in turn could contribute to reduce the risk for mechanical ventilation associated complications, without any detrimental short-term side effects.