Surfactant Replacement Therapy at NICU in Amirkola Children Hospital, Iran; Experience for a Decade

Surfactant replacement therapy (SRT) recruited for neonatal pulmonary diseases other than respiratory distress syndrome (RDS). Different outcomes were obtained from SRT in neonatal lung diseases. This study was carried out to determine the clinical profile, underlying diseases, complications and the outcomes of the neonates who received surfactant replacement therapy at NICU in Amirkola children hospital, a referral hospital in the north of Iran.

In this cross-sectional study, all neonates who received SRT were included during 2000-2009. The more common type of surfactant used was Survanta, but Curosurf and Newfactan were used because of unavailability of Survanta. Age of the neonate at the time of SRT, underlying pulmonary diseases, duration of mechanical ventilation (MV), any complications such as pneumothorax, nosocomial infection, pulmonary hemorrhage, patent ductus arteriosus (PDA) and also mortality rate were recorded.

Out of 213 SRT cases, the frequency of pulmonary lung diseases were as follows: 178(83.56%) RDS, 18(8.45%) pneumonia, 13(6.10%) MAS (Meconium aspiration syndrome) and 4 (1.87%) CHD (Congenital diaphragmatic hernia). The mean gestational age of neonates was 32.32±3.8 weeks and the mean birth weight was 1970 ±875 gr. The mean age of neonate at the time of SRT was 7.3±2.3 hours after birth. The mean duration of MV was 4.05±3.93 days. The prevalence of complications was pneumothorax (42.48%), secondary sepsis (6.05%), PDA (3.67%) and pulmonary hemorrhage (3.42%). Neonatal death occurred in 85 cases. The mortality rate decreased from 48.87% for the first 8 years of the study to 24.88% for the last two years (p=0.003).

According to the results of this study, RDS was the most common pulmonary disease which required SRT and the survival rate of the surfactant treated neonates increased.