Sadık YURTTUTAN, İsmail Kürşad GÖKÇE, Evrim ALYAMAÇ DİZDAR, Fatma Nur SARI, Harika Gözde GÖZÜKARA BAĞ

Geç Preterm ve Term Yenidoğanlarda Sürfaktan Tedavisi; Endikasyonlar ve Sonuçlar

Amaç: Sürfaktan tedavisi (ST) respiratuvar distres sendromlu (RDS) pretermlerde mortalite ve solunumsal morbiditeleri önemli oranda azaltmıştır. Bununla birlikte solunum sıkıntısı olan geç preterm ve term bebeklerin çoğunda RDS dışında akciğer hastalıkları da mevcuttur. Bu hastalıkların bir kısmında sekonder sürfaktan eksikliği gelişmekte ve ST’nin yararı olabilmektedir. Biz geç preterm ve term bebeklerde ST’nin endikasyonlarını ve erken dönem sonuçlarını değerlendirdik. Gereç ve Yöntemler: Ocak 2009 - Aralık 2012 tarihleri arasında ST uygulanan 135 geç preterm ve term bebeğin medikal kayıtları retrospektif değerlendirildi. Hastaların demografik özellikleri, tanıları, sürfaktan uygulama sayısı ve uygulanma zamanı, ST öncesi ve sonrası (1. ve 6. saat) FiO2gereksinimleri, mekanik ventilasyon süresi ve mortalite oranları incelendi. Bulgular: Sürfaktan tedavisi uygulanan 135 geç preterm ve term bebeğin 78’ine (%57.8) RDS dışı akciğer hastalıkları nedeniyle ST verilmiş olup, bu hastaların mekanik ventilasyon süreleri daha uzun, ≥ 2 doz ST gereksinimi, pulmoner hipertansiyon ve mortalite oranları daha yüksekti. RDS’li hastaların ST sonrası 1. ve 6. saatlerdeki FiO2ihtiyacı beklendiği şekilde azaldı (0.60’dan 0.50 & 0.3, p< 0.001). Konjenital pnömonili yenidoğanların %16’sının tekrarlayan sürfaktan dozlarına ihtiyaç duyduğu görüldü. Konjenital pnömonisi olan 42 hastanın da ST sonrası FiO2gereksinimi azaldı (sırasıyla 0.77’den 0.65 & 0.48 ve p

Surfactant Treatment in Late Preterm and Term Newborns; Indications and Outcomes

Objective: Surfactant therapy (ST) has significantly reduced mortality and respiratory morbidities among preterminfants with respiratory distress syndrome (RDS). However, majority of late preterm and term infants with respiratorydistress also suffer from non-RDS lung diseases. In some of these diseases, secondary surfactant deficiency maydevelop and ST can be beneficial. In this study we evaluated the indications and early outcomes of ST in late pretermand term infants.Material and Methods: We retrospectively evaluated the medical records of 135 late preterm and term infants whounderwent ST between January 2009 and December 2012. The clinical characteristics of the patients, their diagnoses,number of surfactant application and time of administration, FiO2 requirements before and after ST (1st and 6thhours),duration of mechanical ventilation, and mortality rate were evaluated.Results: Among135 late preterm and term patients treated with ST, 78 (57.8%) were given ST due to lung disease otherthan RDS and had longer mechanical ventilator duration. In addition, ≥ 2 doses of surfactant requirement, pulmonaryhypertension and mortality rate were found to be higher in these infants. Among patients with RDS, as expected, FiO2requirement was found to decrease in the 1st and 6th hours after ST (0.60 to 0.50 & 0.37 and p

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