Comparison of Nasal Continuous Positive Airway Pressure Therapy with and without Prophylactic Surfactant in Preterm Neonates

Background: Preterm labor is at risk for respiratory distress syndrome (RDS) and sometimes requires to mechanical ventilation (MV) and surfactant therapy. Continuous positive airway pressure (CPAP) and Nasal Continuous positive airway pressure (NCPAP) are the methods of respiratory support especially for using in RDS of neonates. In other method surfactant is administered to babies via tracheal instillation. The aim of study was comparing nasal continuous positive airway pressure (NCPAP) with and without prophylactic surfactant therapy in preterm neonates’ RDS.  Patients and methods:  This is a randomized clinical trial study that performed on eighty newborns (28-34 weeks) who were born in Ali-Ebne-Abitaleb Hospital of Zahedan University of Medical Sciences from October 2008 to September 2010. Subjects were randomly classified in two groups whom received nasal CPAP alone or with surfactant (40 patients in each group).The Including criteria for entrance to research were  approved suggested RDS, gestational age less than 34 weeks and neonates 72 hours after delivery . The data collected through direct observation and questionnaire contained fourteen items. Groups received either surfactant (Curosurf, Parma, Italy) with NCPAP or NCPAP alone. The data analyzed were conducted through SPSS 17.00 version and followed by Crosstab (Pearson Chi-square). Results: Results revealed that six neonates who received only NCPAP   and four patients who received NCAPA plus surfactant required to MACHANICAL VENTILATION (MV) therapy. After a week, 33 neonates who received only NCPAP and 36 patients who received CPAP plus prophylactic surfactant remained alive. There was no significant difference between the groups regarding adverse outcomes (P=0.518). Conclusions: According to the results of this study, NCPAP is affordable as a safe protocol for RDS in preterm neonates. Further research especially with control or placebo groups is required to clarify and validate our findings.