Same-day pediatric surgery

HL surfactant was used for vital indications in 12 newborns with respiratory distress syndrome born at 28-36 weeks weighing 1000-2500 g at birth and postgestation age of up to 48 h, without apparent congenital diseases and evident signs of intrauterine infection and with intraventricular hemorrhages no more severe than of the second degree. Control group consisted of 12 babies with similar condition treated similarly but without surfactant. Surfactant HL was administered endotracheally in a dose of 50 mg/kg twice at 12-h interval. Good effect was attained in 4 newborns, stable deterioration in 2, and no effect in 6 children. The majority of artificial ventilation values were virtually the same in both groups, but 2 days after surfactant, FiO2 was significantly lower in the controls than in experimental group (0.37 +/- 0.05 vs. 0.64 +/- 0.4, p < 0.01), and VEI was higher in the controls (0.33 +/- 0.05 vs. 0.18 +/- 0.03, p < 0.05). VR, MAP, FiO2, and oxygenation index decreased slower in the test group than in the controls. The mean duration of treatment with hypoxic gaseous mixtures and artificial ventilation of the lungs in the test vs. control group were 143 +/- 60 and 288 +/- 45 h vs. 45.5 +/- 8.3 and 200.8 +/- 28.5 h, respectively. The incidence of air leakage syndrome was 83% (10 cases) in the test group and 17% (2 cases) in the control group, chronic pulmonary diseases developed in 3 (25%) babies in the test and in 1 (8.3%) in the control group. Seven (67%) children in the test group developed obstructive changes in the lungs vs. 1 child in the control group. One child (test group) died from causes other than pulmonary. Hospital stay was longer in the test group than in control (14.8 +/- 1.7 vs. 8.3 +/- 1.3 days, p < 0.01).