인공 폐 표면 활성물질 투여를 받은 신생아 호흡곤란 증후군 환아에서 신생아 생존에 관계하는 주산기 인자

Abstract

The current study was performed to investigate the perinatal factors influencing neonatal survival of neonatal respiratory distress syndrome (RDS) patients who received surfactant replacement therapy (SRT). Between January 1999 and June 2001, 108 infants were diagnosed as RDS and treated with artificial bovine surfactant (Newfactan®) and perinatal factors were compared in terms of outcome (survival or expiry group). 83 cases (76.9%) belonged to survival group, 25 cases (23.1%) belonged to expiry group. Preceding fetal distress was significantly common in the expiry group, and average birth weight and gestational age, 1- and 5-minute Apgar scores, were significantly higher in the survival group than in the expiry group. Adequate initial weight loss (1-3% of body weight/day) was significantly common in the survival group. According to the initial response after SRT, the neonatal survival rate was quite different. Neonatal survival rate of good response group(94.3%) was significantly higher than relapse (60%) or poor response group(15.4%). 68% of the neonatal death occurred within 1st week of life, and major causes of neonatal death were pneumothorax (28%), pulmonary hemorrhage (24%), and sepsis (16%). Therefore, an adequate initial weight loss (1-3% of body weight/day) after surfactant replacement therapy, prevention of fetal distress, and adequate treatment of pneumothorax and pulmonary hemorrhage would prelude a good clinical outcome.