"Surfactant Replacement Therapy in Neonatal Respiratory Distress Syndrome: Case Control Study in Rural Hospital, Loni, India."

Abstract

We retrieved information from the neonates born in our hospital from August 2010 to July 2012 with signs of RDS and gestational age >26wks. Neonates with TTN, Congenital pneumonia and with surgical illness were ruled out. Those infants who received surfactant were taken as Cases and those who did not receive surfactant but managed with only CPAP and ventilator support were taken as Controls. Downe’s score (for preterms) and Silverman score (for term neonates) along with chest radiograph was used to assess the severity of RDS and grading was done accordingly. INSURE method was used to instill surfactant followed by nCPAP in Case group and only nCPAP in Control group. Mechanical ventilation (MV) was given in cases requiring it (as per ABG Report). There was significant difference in the outcome of neonates with signs of RDS, who were managed with Surfactant and nCPAP, with or without MV, as compared to those who were managed only with nCPAP, with or without MV but no surfactant. Surfactant administration made a significant difference in the outcome of RDS, with nCPAP. At times MV support was needed but for a shorter duration and lower settings. It is thus recommended that use of surfactant in cases of RDS, particularly moderate to severe cases should become a routine. Respiratory Distress Syndrome, Nasal Continuous Positive Airway Pressure, Mechanical Ventilation.