Determining the effect of surfactant instillation time in the prognosis of RDS

Background: RDS is the most common cause of respiratory problems of preterm infants in NICU and surfactant is its treatment, there is strong recommendation for early use of this drug for more effectiveness .The goal of this study is assessment the effects ofsurfactant instillation time in the prognosis of RDS Material and method: 96 neonates with RDS according to the age of treatment with surfactant were divided in three groups: early (≤6h), late (6-48 h) and very late (≥48 h). The mortality, pneumothorax, pulmonary hemorrhage, IVH, duration of mechanical ventilation and duration of hospital stay were compared. Result: 67.7% neonates were males. Means of gestational age and birth weight was 31.8±3 weeks and 1900±630gm respectively, 41.6% of neonates were in early group, 55.2%in late group and 3.1%| in very late group .The earliest time for instillation of surfactant was first hour and the latest time was 96th hour .The rate of pulmonary hemorrhage, pneumothorax & mortality in early group was more than late & very late groups., but there wasn’t any differences in IVH and mean durationof mechanical ventilation and hospital stay. Conclusion: Although there is evidence that earlier instillation of surfactant has better prognosis in neonates,but in this study prognosis of patients with late and very late treatment was good and this means that delayed utilization of this treatment is useful too. Keyword:neonates,RDS, respiratory distress syndrome, surfactant, preterm