Effect of respiratory distress syndrome treatment by surfactant therapy in King Narai Hospital

Abstract

Objective: To study the effects of surfactant in the treatment of premature infants with respiratory distress syndrome (RDS) and the risk factors affecting the mortality of RDS premature infants.  A retrospective study was conducted on all premature infants diagnosed with moderate to severe RDS and treated with Surfactant in King Narai Hospital. Both babies born in King Narai Hospital or from a community hospital in Lopburi Province Between October 1, 2016 and September 30, 2019, there are 240 people. Collection of fundamental factor, common risk factors, risk factors for pregnancy complications. The data were analyzed using logistic regression and multiple logistic regression in the odd ratio evaluation with p <0.05.

Results: Premature infant patients who were moderate to severe RDS and who received surfactant were male, mean gestational age 30.83 ± 2.80 weeks Mean birth weight 1611.31 ± 510.68 grams, Appgar score at 1 minute, 5.74 ± 1.85, Appgar score at 5 minutes, 7.33 ± 1.37. Survival rate was 85.42%, 35 infant deaths (14.58%). The most common cause of death was sepsis (77.14%), mean duration of ventilator use 17.47 ± 7.62 days, average days in hospital, 44.25 ± 26.26 days, average medical expenses 199,451±602,433.78 baht. The risk factor that significantly increased the posibility of mortality in RDS premature infants (p <0.05) was <30 weeks gestation (OR 4.98, 95% CI 2.09-11.85). Maternal pre eclamsia ( OR 9.89, 95% CI 2.32-42.04), caesarean section (OR 2.28, 95% CI 0.99-5.24). A factor that significantly reduced the possibility of mortality in premature infants with RDS (p <0.05) was surfactant exposure no later than 2 hours after birth (OR 0.47, 95% CI 0.16-0.67).