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Presented at High Frequency Ventilation Conference, Snowbird Utah - April 4-9, 2000
Comparison of Prophylactic and Early Rescue Surfactant Administration in Extremely Premature Newborns with Respiratory Distress syndrome ventilated by High Frequency Oscillatory Ventilation. Plavka R, Kopecky P, Sebron A, et al. Prague Czech Republic.
Study compared giving Curosurf as a prophylactic (in the delivery room) or early rescue (in the nursery after stabilization) treatment for RDS. All babies were ventilated by HFOV using a high volume strategy. In the acute phase of RDS, babies who received prophylactic surfactant had lower mean airway pressure and lower oxygenation index (p<.02). Outcome data showed that the prophylactic surfactant group had less CLD or death (p=.021) less IVH (p=.008) and less severe IVH or PVL (p=.012).
Comment. The treatment groups may not be truly comparable since the rescue group had to reach defined criteria demonstrating that they had significant lung disease before treatment was initiated. Even still, the study makes a good case for giving surfactant in the delivery room for premies < 1000 gm.
Andrew B. Kairalla MD