Effect of surfactant in respiratory distress syndrome as early rescue therapy verses delayed selective therapy in 28 to 32 weeks of gestation
Abstract
Background: This prospective interventional study is designed to compare effect of giving surfactant in Respiratory Distress Syndrome (RDS), stabilized on CPAP, as Early Rescue Therapy verses Delayed Selective therapy in Early Pre-terms 28 to 32 weeks, using INSURE method. The main objectives if the studies are to study survival rate and mortality rate in the two groups and to compare the various complications of RDS and surfactant therapy in two groups.
Methods: Cases were selected from the Preterm newborn, 28-30 weeks of gestation, confirmed cases of RDS on the basis of Chest X-ray findings and shake test, admitted. Total 96 cases were enrolled, out of which 51 randomly allotted to Early Rescue therapy and 45 to Delayed Selective treatment. Surfactants were administered using INSURE technique. Observations, clinical findings, course of treatment, vitals and outcomes were noted. Data was analyzed using appropriate statistical methods. Efforts were made to study maximum parameters to find out, which treatment strategy provides better outcomes and feasible in our settings.
Results: In Early group more cases (68.6%) are discharged than in Delayed group (66.7%). Survival rate is more in Early group. In Early group less mortality is seen 16(31.4%), than in Delayed group 15(33.3%). Mean total duration of stay in NICU is decreased in Early group (7.08±6.209 days) as compared to Delayed group (8.896.±793 days).
Conclusion: Early Rescue Therapy increases the survival rate of preterm than the Delayed selective Treatment. Survival rate is increased when surfactant is administered earlier, less than two hours of life, during the course of RDS. Mortality is reduced in Early administration of surfactant but pulmonary causes of mortality is more in them as compared to Delayed administration, where pulmonary as well as non-pulmonary causes of death both affect the mortality.
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