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Therapeutic use of surfactant in neonatal respiratory distress syndrome

Correlation between pulmonary X-ray changes and clinical data

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Abstract

As part of a multicenter surfactant rescue study, the chest X-rays of 239 preterm and term infants were analyzed. To study the influence of surfactant administration on radiographic appearance, 130 patients with a clinical and radiological diagnosis of typical respiratory distress syndrome were selected, in whom adequate chest x-rays before and within 48 h after treatment were available. Median gestational age was 30 weeks (range 25–38 weeks), median birth weight was 1335 g (range 625–3450). The time of surfactant application ranged between 90 min and 24 h after birth (median 6 h). The most common finding after surfactant administration was uniform (n=47) or disproportionate (n=46) improvement of pulmonary aeration, which showed a significant correlation to posttreatment reduction of oxygen requirement (p<0.001). Asymmetric clearance was more often localized on the right side and usually disappeared within two to five days. Only in 13 patients no change of ventilation was found. Development of interstitial emphysema (n=24, including three patients with pneumothorax) after surfactant treatment was an unfavourable prognostic sign. 54% of these patients (13 of 24) died within the first month of life, compared to 8% (7 of 93) in the group of patients with initial improvement of ventilation.

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Authors and Affiliations

  1. Department of Radiology, University of Münster, Albert-Schweitzer-Strasse 33, W-4400, Münster, FRG

    U. Bick & N. Roos

  2. Department of Pediatrics, University of Münster, Albert-Schweitzer-Strasse 33, W-4400, Münster, FRG

    G. Jorch & J. Meyer zu Wendischhoff

  3. Department of Radiology, University of Aachen, FRG

    C. Müller-Leisse

  4. Department of Pediatrics, University of Aachen, FRG

    H. Hörnchen

  5. Department of Radiology, University of Heidelberg, FRG

    J. Tröger

  6. Department of Pediatrics, University of Heidelberg, FRG

    O. Linderkamp

  7. Franziskus Hospital Münster, FRG

    U. Flothmann

  8. Department of Pediatrics, University of Mannheim, FRG

    W. Kachel

  9. Department of Pediatrics, University of Düsseldorf, FRG

    P. Lemburg

  10. Children's Hospital Hamburg Altona, FRG

    Ch. Pörksen

  11. Department of Pediatrics, University of Kiel, FRG

    H. Schroeder

  12. Children's Hospital Passau, FRG

    F. Staudt

  13. Children's Hospital Gelsenkirchen, FRG

    A. Sychlowy

  14. Children's Hospital Hamm, FRG

    G. Wiese

  15. Children's Hospital Hildesheim, FRG

    R. Galaske

Authors
  1. U. Bick
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  2. C. Müller-Leisse
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  3. J. Tröger
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  4. G. Jorch
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  5. N. Roos
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  6. J. Meyer zu Wendischhoff
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  7. U. Flothmann
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  8. W. Kachel
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  9. P. Lemburg
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  10. O. Linderkamp
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  11. H. Hörnchen
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  12. Ch. Pörksen
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  13. H. Schroeder
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  14. F. Staudt
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  15. A. Sychlowy
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  16. G. Wiese
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  17. R. Galaske
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Bick, U., Müller-Leisse, C., Tröger, J. et al. Therapeutic use of surfactant in neonatal respiratory distress syndrome. Pediatr Radiol 22, 169–173 (1992). https://doi.org/10.1007/BF02012487

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  • DOI: https://doi.org/10.1007/BF02012487

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