KẾT QUẢ ĐIỀU TRỊ BỆNH MÀNG TRONG BẰNG BƠM SURFACTANT QUA KỸ THUẬT LISA Ở TRẺ SƠ SINH NON THÁNG TẠI BỆNH VIỆN CHUYÊN KHOA SẢN NHI SÓC TRĂNG

Abstract

Background: Hyaline membrane disease is a common problem in preterm infants. This disorder is caused primarily by deficiency of pulmonary surfactant in an immature lung. Less invasive surfactant administration (LISA) is an effective treatment method, prioritizing infants who can still breathe spontaneously with continuous positive airway pressure (CPAP). This method is less invasive and helps avoid complications associated with mechanical ventilation. Objectives: 1) To describe the clinical and paraclinical characteristics of hyaline membrane disease in preterm infants indicated for surfactant administration via the LISA method. 2) To evaluate the treatment outcomes of hyaline membrane disease using the LISA method in preterm infants. Materials and Methods: This descriptive case series study included 35 preterm infants diagnosed with hyaline membrane disease and indicated for surfactant administration via the LISA method at Soc Trang Hospital for Women and Children from 01/05/2024 to 31/01/2025. Results: Males accounted for 57.1% of the study population, with a mean gestational age of 31.7 ± 2.9 weeks and an average birth weight of 1732.8 ± 579.7 g. Antenatal corticosteroid prophylaxis was administered in 37.1% of cases. Severe respiratory distress was observed in 82.9% of infants, and early-onset neonatal infection was detected in 31.4%. Hyaline membrane disease severity distribution was as follows: grade 2 (49.2%), grade 3 (51.4%), and grade 4 (5.7%). Blood gas analysis showed respiratory acidosis in 37.1%, metabolic acidosis in 14.3%, and mixed acidosis in 48.6%. Surfactant administration via LISA significantly reduced the fraction of inspired oxygen (FiO₂) requirement at 1 hour and 6 hours post-treatment (mean FiO₂ decreased from 47.4% pre-treatment to 28.5% at 1 hour and 23.1% at 6 hours). After 6 hours, the proportion of grade 3 hyaline membrane disease decreased from 51.4% to 2.9%, and no cases of grade 4 hyaline membrane disease remained. Blood gas abnormalities improved significantly (p<0.05). The overall treatment success rate was 82.9%, while 17.1% experienced treatment failure. Conclusion: Administration of surfactant via the LISA method in preterm infants with hyaline membrane disease is highly effective and should continue to be implemented.