NGHIÊN CỨU ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ KẾT QUẢ ĐIỀU TRỊ BỆNH MÀNG TRONG BẰNG BƠM SURFACTANT QUA KỸ THUẬT LISA Ở TRẺ SƠ SINH NON THÁNG TẠI BỆNH VIỆN PHỤ SẢN THÀNH PHỐ CẦN THƠ

Abstract

Background: Hyaline membrane disease is a common problem in preterm infants. This disorder is caused primarily by a deficiency of pulmonary surfactant in an immature lung. The less invasive surfactant administration (LISA) for the treatment of respiratory distress syndrome has been proven to be effective, safe and feasible and is being applied in many parts of the world. Objectives: 1) To describe clinical, paraclinical features and treatment of hyaline membrane disease in preterm neonates with LISA method. 2) Evaluation of the resulting value and some unsuccessful factor associations with the surfactant replacement with LISA method. 3) Investigate some factors related to treatment failure in the surfactant replacement with LISA method. Materials and methods: A cross-sectional study was conducted on 169 premature infants diagnosed with respiratory distress syndrome. They were admitted to the Neonatology Department at the Can Tho Gynecology Obstetrics Hospital from 01/2019 - 12/2020. Results: The rate of male was 59.2%, the average gestational age was 31.3 ± 2.7 weeks and the infant birth weight was 1576 ± 463 grams. There were 29.6% of patients having severe level of respiratory failure and the rate of grade II, III based on X-ray image was 78.7%. The rate of early-onset neonatal infections was 15.4%. Surfactant replacement reduces FiO₂ concentration (53.1% vs 32.8) and increases SpO₂ (88.6% vs 94.1%). Especially, 6 hours after supplement, the rate of grade III based on X-ray reduces from 86.7% to 31.1%. The success rate was 62.2%. The rate of mortality was 37.8%. Relevant factors to failure treatment were gestation, birth weight, early-onset neonatal infection (OR=5.33, p=0.034), infants having severe levels of respiratory failure (OR=5.63, p=0.029). Conclusion: The treatment of hyaline membrane disease using surfactant for preterm neonates showed positive results and should be implemented to save premature infant lives.