Effects of Pulmonary Surfactant Dose Selection in Late Preterm Infants with Respiratory Distress Syndrome

Cuilian Xiong, Qinghong Yang and Zhuling Zheng

Background and Objective: Pulmonary surfactant, a lipoprotein from type II alveolar epithelial cells, reduces alveolar surface tension, restores alveolar function and enhances oxygenation, but optimal dosage remains uncertain in clinical practice. This study investigated the impact of different doses of pulmonary surfactant (PS) on blood gas indices, cerebral oxygen metabolism and complications in late preterm infants with Neonatal Respiratory Distress Syndrome (NRDS). Materials and Methods: A retrospective analysis of clinical data from 105 late preterm infants with NRDS was conducted, which were divided into low-dose group (LDG) (n = 27, starting dose of 100 mg/kg), medium-dose group (MDG) (n = 48, starting dose of 200 mg/kg) and high-dose group (HDG) (n = 30, starting dose of 250 mg/kg) groups. The three groups were compared in terms of clinical efficacy, treatment duration, complications and developmental status during follow-up. Results: The total effective rate was significantly higher in the HDG than in the LDG (p<0.05). The duration of mechanical ventilation, oxygenation and hospitalization was shorter in the HDG than in the MDG and LDG and shorter in the MDG than in the LDG (p<0.05). The HDG had higher levels of PaO₂, PaO₂/FiO₂, SOD and GSH-Px than the MDG and LDG and lower levels of PaCO₂, MDA, IL-6, IL-8 and TNF-α. The MDG had higher levels of PaO₂, PaO₂/FiO₂, SOD and GSH-Px than the LDG and higher levels of FiO₂, SOD and GSH-Px than the LDG, while having lower levels of PaCO₂, MDA, IL-6, IL-8 and TNF-α (p<0.05). Conclusion: The PS can effectively improve blood gas indices and cerebral oxygen metabolism in late preterm infants with NRDS. The starting dose of 250 mg/kg PS is more beneficial than 100 and 200 mg/kg.

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