167 INFLUENCE OF CLINICAL FACTORS ON MORTALITY AND MORBIDITY IN INFANTS WITH SERVERE RESPIRATORY DISTRESS SYNODROME (RDS) FOLLOWING SURFACTANT REPLACEMENT THERAPY

Abstract

In an international multicenter trial infants with clinical and radiological signs of severe RDS were randomized to receive either a single dose (n=176) or three subsequent doses (n=167) of a porcine natural surfactant (Curosurf). Using a logistic regression model the effects of therapy, birth weight, sex, and other clinical factors on survival and various outcome parameters were evaluated. Results: Mortality (13vs.21%, p<0.05) and the incidence of pneumothoraces (9vs. 18%, p<0.01) were significantly lower in the multiple-dose group. Low birth weight, hospital allocation, low Apgar and initial disease severity were associated with an increased mortality. Low birth weight, hypothermia (admission temperature <36°C) and acidosis (pH<7.25) prior to surfactant treatment could be identified as risk factors for the development of an intracranial hemorrhage. Conclusion: Mortality and the incidence of pneumothoraces were significantly reduced after multiple-dose treatment of severe RDS as compared to a single dose regimen. 28 day outcome in surfactant treated infants is influenced by various clinical factors.