TREATMENT OF RESPIRATORY DISTRESS-SYNDROME IN PRETERM NEWBORNS WITH THE USE OF EXOGENOUS SURFACTANT (PORACTANT ALFA): CLINLCAL GUIDLINES

Abstract

Respiratory distress-syndrome (RDS) is an acute lung disease that occurs mainly in pretermnewborns due to deficiency of pulmonary surfactant and immaturity of the respiratory system. Its symptoms appear shortly after birth, and the clinical course in the absence of treatment is characterized by a worsening condition during the first 2 days of life.Despite the improvement and effectiveness of the prevention and treatment of RDS, this disease remains an important cause of death in newborns. According to European data, mortality associated with RDS can reach 10%, and according to the latest official statistical data from the United States, this disease ranks 8thamong the most important causes of death in infants.According to official statistical data from obstetrical hospitals, the incidence of RDS in Ukraine in 2016 was 194 cases per 1000 premature babies. The majority of patients in modern Ukrainianneonatal intensive care units die from the complications associated with this disease, especially intraventricular hemorrhages.The clinical recommendations contain sections on the etiology, pathogenesis, clinical presentation, antenatal prevention of RDS with recommendations for stabilizationafter birth and further,at the neonatal intensive care unit. Separately, the metabolism of surfactant, the importance of drug selection and the correct dose of surfactant use, practical recommendations on its use, indications, preparation for use and administration techniques are presented taking into account the international evidence-based data.Clinical guideline was elaborated for neonatologists, pediatric anesthesiologists and residents to improve the quality of medical care for preterm newborns at risk for developing or having RDS; the optimization of methods of medical care for preterm newborns to decrease the incidence of the disease, development of complications and mortality of premature babies at risk for or developing RDS.