In Management of NRDS, Mechanical Ventilation alone or Mechanical Ventilation + Surfactant An Indian Experience

Method & Design

• 207 babies with HMD requiring mechanical ventilation were admitted in NICU
• 88 babies with mean gestational age of 30 weeks received surfactant, rest did not

Results

Survival by Gestational Age

Surfactant therapy significantly reduced mortality

Complication Rate / Morbidities

Surfactant therapy significantly reduced complication rate or morbidities

Duration of Mechanical Ventilation

• Duration of mechanical ventilation was 44.1 hrs less in surfactant group

NICU & Hospital Stay in Survivors

• The mean duration of NICU stay was 2.15 days less in surfactant group
• The mean duration of hospital stay was 4.37 days less in surfactant group

Conclusion

Surfactant therapy for babies with NRDS who are mechanically ventilated

• Improves survival
• Reduces morbidity
• Reduces duration of mechanical ventilation
• Reduces hospital stay
• Reduces NICU STAY

Thus though surfactant therapy appears expensive initially, it's impact on reducing duration of mechanical ventilation, NICU stay and morbidities actually decreases the total cost. The hospital cost decreases by 16-22 %.

Indian Pediatrics 2001; 38: 640-646