Single Versus Multiple Doses of Surfactant Treatment in Preterm Infants

Aim: Exogenous surfactant may be needed not only for Respiratory Distress syndrome (RDS) treatment; but also, in the management of other pulmonary diseases of infants. In this study, we aimed to investigate the impact of single versus multiple doses of surfactant therapy in pulmonary problems of preterm infants. Materials and Methods: In this study, preterm infants who needed surfactant treatment were retrospectively evaluated. Surfactant therapy for RDS were given as 200 mg/kg poractant or 100 mg/kg beractant and repeated with 100 mg/kg doses when needed later. Poractant or beractant (100 mg/kg) were given in the treatment of other pulmonary diseases. Results: Totally 64 preterm patients were recruited into this study. Patients in group 1 (43.8%) received a single dose of surfactant; whereas group 2 patients (56.2%) had more than one dose. Mean gestational age and birth weight of infants in group 2 were significantly lower than group 1 (p<0.05). Intrauterine growth restriction (IUGR) was more common in group 2 (p=0.041). Multiple doses of surfactant were needed for severe RDS, atelectasis, pulmonary hemorrhage and pneumonia. Duration of mechanical ventilation and hospitalization were longer in group 2 (p<0.05). Mortality rates were higher in group 2 (p=0.011). Conclusion: Preterm infants with earlier gestational age and lower birth weight; particularly with IUGR may need multiple doses of surfactant due to more severe respiratory problems regardless of antenatal steroid or maternal chorioamnionitis status. Duration of mechanical ventilation, hospitalization and also neonatal mortality remained higher due to disease severity in preterms who needed multiple doses of surfactant.