Published: 2017-01-02

Single dose surfactant early rescue therapy in respiratory distress syndrome-experience and outcome at a tertiary care centre

Keerti Swarnkar, Manish Swarnkar


Background: Neonatal respiratory distress syndrome (RDS) is a progressive respiratory failure that is caused primarily by a deficiency of pulmonary surfactants (PS). We undertook a prospective study to evaluate outcomes of neonatal respiratory distress syndrome (RDS) patients treated with early rescue pulmonary surfactant.

Methods: This was a prospective cross sectional study conducted at level III NICU. A total of 47 eligible  patients out of 142 diagnosed RDS on chest x-ray or FiO2 ≥40 was needed to reach SpO2 between 85 and 93%  received early recue surfactant therapy (within 2hrs of life) and  maternal ,neonatal and clinical data was analysed using SPSS software.

Results: In this study prevalence of RDS amongst neonates admitted in NICU was 16.4%, early rescue surfactant therapy could be given only to 47 cases. There was male predominance (2.62:1). Mean age of administration of surfactant was 1.30±0.8 hr and Antenatal steroid was given in only 21.3% of mothers. Fraction of inspired oxygen concentration (Fio2) requirement also significantly decreases before and after therapy (p value˂0.0001) at 6,12, and 24 hrs. PEEP also shows decreasing trend at 24 hrs (p value ˂0.05). Sepsis was the commonest complication leading to mortality.

Conclusion: Implementation of early rescue administration of surfactant in infants at high risk for developing RDS in neonatal ICU is a safe and effective modality of respiratory support which decreases ventilatory requirements, improves respiratory status, and causes early extubation.



Respiratory distress syndrome, Early rescue, Surfactant, Ventilatory parameters, Fraction of inspired oxygen

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