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  |   1602_101-109.pdf
J Korean Soc Neonatol. November;16(2):101-109.
Copyright ⓒ 2009 The Korean Society of Neonatology Neonatal Medicine
The Importance and the Need of Early Pulmonary Surfactant Therapy in Premature Infant with Respiratory Distress Syndrome
Sung Mi Kim, M.D., Hye Sun Yoon, MD. Ph.D.*, Ki Soo Kim, M.D., Ph.D.† and Chong-Woo Bae, M.D., Ph.D.‡
Department of Pediatrics, Busan St. Mary's Medical Center, Busan, Korea, Department of Pediatrics*, Eulji University School of Medicine, Seoul, Korea, Department of Pediatrics†, Asan Medical Center, Ulsan University, Seoul, Korea, Department of Pediatrics‡, Kyunghee University East-West Medical Center Seoul, Korea
ABSTRACT
Pulmonary surfactant (PS) therapy in premature infants has a remarkable impact on improving survival and outcomes in neonatal respiratory distress syndrome (RDS). Early PS therapy involves instillation of PS upon delivery of very premature infants or if there is evidence of RDS, such as an increased requirement of oxygen 2 hours after birth, especially in infants <30 weeks gestation. Early PS treatment in very premature infants results in a significant reduction in the severity of RDS, mortality, and incidence of pneumothorax, pulmonary interstitial emphysema, and bronchopulmonary dysplasia in comparison with late PS treatment. According to European and American consensus guidelines on the management of neonatal RDS, early PS instillation should be considered for infants <30 weeks gestation, infants with a birth weight <1,250 g, or if the mother has not received antepartum corticosteroids. We suggest that the Korean health insurance policy on RDS be modified so that PS can be used for better clinical outcomes of very premature infants.
Keywords: Respiratory Distress Syndrome, Early, Therapy, Pulmonary surfactant, Premature infant, Outcome, Prognosis
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