145 Evaluation of Surfactant Therapy in HMD and Reduction of Mortality

Abstract

HMD Occurs Primarily in premature infants, and its incidence is inversely proportional to gestational age and birth weight. HMD is a Major cause of morbidity and mortality in preterm neonates. (about 30%) Surfactant deficiency is the primary cause of HMD in Previous studies, surfactant therapy has reduced mortality from HMD approximately 40% the aim of this research was determined the incidence of mortality in neonates with HMD after treatment with surfactant.Methods & materials: In this study that was a descriptive analytic study, we evaluated 450 neonates with HMD, who were admitted to NICU in Beheshti Hospital Isfahan Iran, between Mar 2003 to Aug 2004. After diagnosis of HMD by clinical signs of Respiratory distress, and radiological findings of the chest, 89 Patients received surfactant (Males 58 and females 31)Results: A group of 34 (38.2%) out of 89 neonates who received surfactant survived HMD, on the other hand, in this study surfactant therapy has reduced mortality from HMD (38.2%), 42% were females and 36.2% were males. The most efficacy of surfactant therapy and low mortality were observed on gestational age more than 32 weeks, and therapy in the Ist 24 hr of life (47.5%and 43.3% respectively). Also the most efficacy of surfactant were showed in APGAR score at 1, 5 min more than 7/10 and in birth weight more than 1500 Gr (48% and 52.5% respectively). In this study, mothers who received steroid before delivery and their neonates who took surfactant after birth, had the most efficacy and reduction of mortality (41.7% with steroid and 34.15% without steroid).CONCLUSIONS: The purpose of this study was detection the prevalence rate of reduction of mortality after surfactant therapy in HMD, our study was showed reduction of mortality and also was concluded the most efficacy of surfactant therapy on some condition which associate with HMD.