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| Influence of two different techniques of pulmonary surfactant administration for treating premature infants with distress syndrome and dyspnea on their pulmonary function and adverse reactions |
| 1.Shengzhou Maternal and Child Health Care Hospital, Shaoxing Zhejiang Province, 312400; 2.Shengzhou People's Hospital, Shaoxing |
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Abstract To compare the influence of the different techniques of pulmonary surfactant (PS) administration for treating premature infants with neonatal respiratory distress syndrome (NRDS) on their pulmonary function and adverse reactions. Methods: 105 premature infants with NRDS selected and were divided into control group (n=52) and observation group (n=53) by simple randomization method with the help of random number table from August 2019 to August 2023. The infants in the control group were treated with PS administration by tracheal intubation-use of pulmonary surfactant-extubation technique (INSURE) combined with caffeine, while the infants in the observation group were treated with PS administration by minimally invasive pulmonary surfactant administration technique (LISA) combined with caffeine. The curative effect at 24h after treatment, the values of pulmonary function indexes at the time of the infants with the corrected age of 36 weeks, such as tidal volume (VT), respiratory rate (RR), minute ventilation (MV), time to peak value ratio (TPTEF/TE), peak volume ratio (VPEF/VE), expiratory flow at 25%, 50% and 75% of tidal volume (FEF25%, FEF50%, FEF75%), the values of respiratory mechanics indexes before treatment and at 24 h after treatment, such as airway resistance, static lung compliance and endogenous positive end-expiratory pressure (PEEP), the values of blood gas analysis, such as partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2) and pH, the values of the time indexes of the infants received treatment, such as dyspnea disappeared time, total noninvasive ventilation time and the hospital stay, the adverse reactions rate during the medication and the incidence of complications during hospitalization of the infants were compared between the two groups. Results: After 24 hours of treatment, the curative effect (94.3%) of the infants in the observation group was significantly higher than that (88.8%) of the infants in the control group. When the infants reached the corrected age of 36 weeks, the values of RR, airway resistance and endogenous PEEP of the infants in the observation group were significantly lower than those of the infants in the control group. The values of MV, TPTEF/TE, VPEF/VE, FEF25%, FEF50% and FEF75%, and the static lung compliance of the infants in the observation group were significantly higher than those of the infants in the control group. The values of some indexes of blood gas analysis of the infants in the two groups were significantly recovered compared with those before treatment. The PaO2 and pH values of the infants in the observation group were significantly higher than those of the infants in the control group, and the PaCO2 value of the infants in the observation group was significantly lower than that of the infants in the control group (all P<0.05). The time of hospital stay (18.63±1.83d) of the infants in the observation group was significantly shorter than that (20.57±2.07d) of the infants in the control group (all P<0.05). There were no significant differences in the various adverse reactions and the incidence of complications of the infants between the two groups (P>0.05). Conclusion: The PS administration by both INSURE technique and LISA technique combine with caffeine for treating the premature infants with NRDS are effective, but LISA technique is more effective, which has good influence on the pulmonary function, respiratory function and blood gas value of the premature infants, and can promote the rehabilitation of the infants, and without increase of the incidence of adverse reaction and complications of the infants during medication and hospitalization.
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