Background Prophylactic and early surfactant replacement (SF) therapy reduces mortality and morbidity in premature infants. The number of recommended doses enormous issue of argument in current literature.
Objective Correlation of laboratory findings and oxygenation indexes immediately after the prophylactic administration of SF with the necessity of a second or a third dose of SF in preterm neonates.
Materials and Methods We retrospectively studied 142 premature neonates with gestational age (GA) between 25–32 weeks, that received early SF replacement therapy of porcine type (200 mg/kg, Curosurf®), in less than 20 minutes after birth. Enrolled infants were divided in two groups according to the SF doses (group A: one dose and the group B: more than 1 dose). We registered prospectively blood gases values and oxygenation estimation indexes after the prophylactic SF treatment.
Results The collected data included 142 neonates, 32 (22.5%) of which received more than 1 dose of SF (group B). Blood gases values of pH and SBE differ significantly between neonates who received 1 dose (group A) and those who received more SF doses (7.34 vs 7.31, p = 0.04 and −2.92 vs −5.46, p<0.001 respectively). Moreover, we noticed that all oxygenation estimation indexes differ significantly between the two groups (oxygenation index: 6.28 vs 2.66, p = 0.002, alveolar-arterial difference: 137.5 vs 76.6, p = 0.002, arterial/alveolar ratio: 0.45 vs 0.54, p = 0.02).
Conclusions Our data demonstrates that decreased SBE and pH values as well as oxygenation estimation indexes, soon after prophylactic therapy, represent prognostic factors that predict the necessity of repeated administration of SF replacement therapy.