Évolution des paramètres gazométriques sur les 24 premières heures suivant l'administration d'Exosurf ®

Abstract

Background. —There is now good evidence that the clinical course of infants with respiratory distress syndrome can be improved by treatment with exogenous surfactant. However, optimal methods of giving such a treatment are still debated. Population and methods. —The arterial blood gases and the arterial/alveolar oxygen tension ratio (a/A) were recorded during the 24 hours following artificial surfactant (Exosurf ®) treatment in 400 newborns aged 25 to 42 gestational weeks. A positive response was defined by an a/A ratio > 0.22 or an increase in a/A ratio up to 25%. Results. —After administration of the first dose, a positive response was obtained in 63% of cases during the first 6 hours and 11% during the 6 following hours. The response after the second dose was favourable in 75% of cases. At 24 hours after treatment, 36% of the infants had obtained an a/A ratio > 0.22. Conclusion. —Because of the 18% of infants who responsed positively only after the second dose, administration of this dose seems justifiable even in case of non-response to the first dose. The quality of the response is related to the severity of the pulmonary iliness but is independent of the gestational age.