Early versus late extubation after surfactant replacement therapy for respiratory distress syndrome

Abstract

Patients and methodsNinety patients treated by surfactant replacement therapy were included in the study. Patients were divided into 2 groups; group A consists of patients who were extubated early within 24h after surfactant administration and group B consists of patients who were extubated after 24h from surfactant administration. Results59 patients were extubated early (within 24h after surfactant administration) while 31 patients were extubated late (after 24h from surfactant administration). Patients in group B (late extubation group) had a longer duration of CPAP (41.53+9.74h in group B versus 17.30+4.03h in group A), a longer duration of total oxygen administration (73.41+11.24h in group B versus 45.33+5.22h in group A) and a longer duration of hospital stay (171.88+75.74h in group B versus 106.82+52.79h in group A) than patients in group A (early extubation group). 41 (69.50%) Patients who were extubated early received surfactants at or before the age of 6h while 22 (70.97%) patients who were extubated late received surfactants after the age of 6h. Regarding complications, 6 patients had transient bradycardia (6.7%), 4 patients had pneumothorax (4.4%) and 4 patients had pulmonary hemorrhage (4.4%). ConclusionEarly administration of surfactants is associated with early extubation. Patients who were extubated early (most of them had an early administration of surfactants) had a lower chance for re-intubation, less duration of total oxygen administration and less hospital stay.