The Effects Of Exogenous Pulmonary Surfactant In1ate Preterm Infant Treating Acute Respiratory Failure

Objective:This study was to investigate the effects of exogenous pulmonary surfactant in1ate preterm infant treating acute respiratory failure.Methods:Adopted sixty examples of acute respiratory failure in late preterm infant coming from Qingdao Women and Children Hospital received by the division from2010-1to2011-6, divided them into two groups according to whether the parents agreed to use PS. The treated group was injected Calf pulmonary surfactant and the matched group was given nothing. The two groups are required to use mechanical ventilation treatment. Recorded in1h6h24h after treatment with clinical symptoms, respiratory distress score, blood gas analysis, breathing machine parameters, inflammatory cytokines(IL-6、IL-8、TNF-a), hospital days and the complications may occurred.Results1、In the treatment group,1hours after using PS, the cyanosis improved in20patients, transcutaneous oxygen saturation (SPO2) rose to more than90%in18patients, Three concave syndrome were relieved or disappeared in17patients. In the matched group cyanosis improved in23patients, SPO2rose to more than90%in25patients, Three concave syndrome were relieved or disappeared in21patients. The two groups were repeated neonatal respiratory distress score in1h6h after the application of PS, the difference was statistically significant(P<0.05).2、In the treated group, the result of blood gas analysis was significantly decreased in PCO2after using PS lhour and in TCO2after24hour and increased in PO2after using PS lhou、6hour and24hour. The result has been a statistical significant difference(P<0.05).3、In the treated group, the result of common parameters of ventilator was significantly decreased in FiO2、PEEP、PIP, OI was increased more, the continued times of mechanical ventilation was less than the matched group. And it’s esaier to remove the respirator. The result has been a statistical significant difference(P<0.05).4、In the treated group, the complications and comorbidities causing of mechanical ventilation was less than the matched group. It occered6samples of complications, including2samples of patent ductus arteriosus (9.10%),4samples of pulmonary infectious diseases(18.18%). In the observed group, it occered13samples of complications, containing2samples of patent ductus arteriosus (PDA7.89%),4samples of pulmonary infectious diseases (10.53%),5samples of pneumothorax (13.16%) and1sample of pulmonary artery hypertension (2.63%)5、There were28serum samples of late preterm infants conforming the requires.9samples came from the treated group, others (19samples) came from the matched group. It demonstrated that the interleukin-6(IL-6). interleukin-8(IL-8) and tumor necrosis factor-alpha (TNF-a) were significantly decreased after removing the respirator. The varieties of IL-8were significant decreased in the treated group. Other two inflammatory cytokines didn’t occur. The result had been a statistical significant difference (P<0.05).6、In the treatment group,20patients were cured,2patients death or abandoned treatment, and the length of hospital stay were(13.55±4.43) days, hospital costs (8352.82±4767.89) element; in the matched group,35patients were cured, and3patients were death or abandoning treatment, the length of hospital stay were(18.05±7.72) days, hospital costs (13128.62±4544.12) element. The difference has been a statistical significance (P<0.05).Conclusions Using exogenous pulmonary surfactant in1ate preterm infant treating acute respiratory failure is obviously useful.