The efficacy of intra-tracheal budesonide with surfactant in treatment of respiratory distress syndrome and prevention of bronchopulmonary dysplasia
Background: Premature birth is an important issue in developed and developing countries. Surfactant replacement therapy of respiratory distress syndrome (RDS) causes a change in the normal pattern of the disease and increases the likelihood of survival of more premature newborns with chronic pulmona...
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| Format: | Article |
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Tabriz University of Medical Sciences
2021-04-01
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| Series: | مجله پزشکی دانشگاه علوم پزشکی تبریز |
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| Online Access: | https://mj.tbzmed.ac.ir/PDF/mj-43-1-48.pdf |
| _version_ | 1811224984835588096 |
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| author | Manizheh Mostafa Gharehbaghi Shalale Ganji Majid Mahallei |
| author_facet | Manizheh Mostafa Gharehbaghi Shalale Ganji Majid Mahallei |
| author_sort | Manizheh Mostafa Gharehbaghi |
| collection | DOAJ |
| description | Background: Premature birth is an important issue in developed and developing countries. Surfactant replacement therapy of respiratory distress syndrome (RDS) causes a change in the normal pattern of the disease and increases the likelihood of survival of more premature newborns with chronic pulmonary damage. The purpose of this study was to investigate the effects of budesonide and surfactant on the treatment of respiratory distress syndrome and the prevention of bronchopulmonary dysplasia. Methods: In a randomized clinical trial, 128 preterm infants less than 1250 g or gestational age of 26-30 weeks that were admitted to Al-Zahra Hospital from 2017 to 2018 with RDS and needed surfactant replacement therapy were enrolled. They were randomly allocated into two groups. In one group (group Surfactant), the surfactant was administered intratracheally 2.5 cc/kg and in the second group (group Surfactant + Budesonide), budesonide was administered 0.25 mg/kg in addition to the intratracheal surfactant. The primary outcome was bronchopulmonary dysplasia and the secondary outcome was complications of prematurity. Results: In this study 128 neonates including 48 (60.9%) boys and 50 (39.1%) girls were studied. The mean gestational ages of studied neonates were 28.32±1.60 weeks. The mean duration of mechanical ventilation, continuous positive airway pressure (CPAP), high flow nasal cannulae (HFNC), and need for supplemental oxygen were significantly shorter in the group that received surfactant and budesonide combination. The required FiO2 at four hours after surfactant treatment was significantly lower in group Surfactant + Budesonide than the Surfactant group (p = 0.01). In the group Surfactant, 38 neonates (59.4%) and in group S+B, 24 cases (37.5%) developed bronchopulmonary dysplasia (BPD), (p = 0.04). The mortality rate was 15 neonates that 6 cases were in group S+B (p =0.29). Conclusion: In our study, using surfactant with budesonide combination in comparison with surfactant alone is associated with less respiratory support and BPD rate. Future studies with a larger number of patients before routine use of surfactant and budesonide combination is recommended. |
| first_indexed | 2024-04-12T08:58:09Z |
| format | Article |
| id | doaj.art-3e453829770d409c915afb0ffed629f7 |
| institution | Directory Open Access Journal |
| issn | 2783-2031 2783-204X |
| language | fas |
| last_indexed | 2024-04-12T08:58:09Z |
| publishDate | 2021-04-01 |
| publisher | Tabriz University of Medical Sciences |
| record_format | Article |
| series | مجله پزشکی دانشگاه علوم پزشکی تبریز |
| spelling | doaj.art-3e453829770d409c915afb0ffed629f72022-12-22T03:39:18ZfasTabriz University of Medical Sciencesمجله پزشکی دانشگاه علوم پزشکی تبریز2783-20312783-204X2021-04-01431485410.34172/mj.2021.02727152The efficacy of intra-tracheal budesonide with surfactant in treatment of respiratory distress syndrome and prevention of bronchopulmonary dysplasiaManizheh Mostafa Gharehbaghi0Shalale Ganji1Majid Mahallei2Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, IranFaculty of Medicine, Tabriz University of Medical Sciences, Tabriz, IranFaculty of Medicine, Tabriz University of Medical Sciences, Tabriz, IranBackground: Premature birth is an important issue in developed and developing countries. Surfactant replacement therapy of respiratory distress syndrome (RDS) causes a change in the normal pattern of the disease and increases the likelihood of survival of more premature newborns with chronic pulmonary damage. The purpose of this study was to investigate the effects of budesonide and surfactant on the treatment of respiratory distress syndrome and the prevention of bronchopulmonary dysplasia. Methods: In a randomized clinical trial, 128 preterm infants less than 1250 g or gestational age of 26-30 weeks that were admitted to Al-Zahra Hospital from 2017 to 2018 with RDS and needed surfactant replacement therapy were enrolled. They were randomly allocated into two groups. In one group (group Surfactant), the surfactant was administered intratracheally 2.5 cc/kg and in the second group (group Surfactant + Budesonide), budesonide was administered 0.25 mg/kg in addition to the intratracheal surfactant. The primary outcome was bronchopulmonary dysplasia and the secondary outcome was complications of prematurity. Results: In this study 128 neonates including 48 (60.9%) boys and 50 (39.1%) girls were studied. The mean gestational ages of studied neonates were 28.32±1.60 weeks. The mean duration of mechanical ventilation, continuous positive airway pressure (CPAP), high flow nasal cannulae (HFNC), and need for supplemental oxygen were significantly shorter in the group that received surfactant and budesonide combination. The required FiO2 at four hours after surfactant treatment was significantly lower in group Surfactant + Budesonide than the Surfactant group (p = 0.01). In the group Surfactant, 38 neonates (59.4%) and in group S+B, 24 cases (37.5%) developed bronchopulmonary dysplasia (BPD), (p = 0.04). The mortality rate was 15 neonates that 6 cases were in group S+B (p =0.29). Conclusion: In our study, using surfactant with budesonide combination in comparison with surfactant alone is associated with less respiratory support and BPD rate. Future studies with a larger number of patients before routine use of surfactant and budesonide combination is recommended.https://mj.tbzmed.ac.ir/PDF/mj-43-1-48.pdfbronchopulmonary dysplasiabudesonidepremature infantsrespiratory distress syndromesurfactant |
| spellingShingle | Manizheh Mostafa Gharehbaghi Shalale Ganji Majid Mahallei The efficacy of intra-tracheal budesonide with surfactant in treatment of respiratory distress syndrome and prevention of bronchopulmonary dysplasia مجله پزشکی دانشگاه علوم پزشکی تبریز bronchopulmonary dysplasia budesonide premature infants respiratory distress syndrome surfactant |
| title | The efficacy of intra-tracheal budesonide with surfactant in treatment of respiratory distress syndrome and prevention of bronchopulmonary dysplasia |
| title_full | The efficacy of intra-tracheal budesonide with surfactant in treatment of respiratory distress syndrome and prevention of bronchopulmonary dysplasia |
| title_fullStr | The efficacy of intra-tracheal budesonide with surfactant in treatment of respiratory distress syndrome and prevention of bronchopulmonary dysplasia |
| title_full_unstemmed | The efficacy of intra-tracheal budesonide with surfactant in treatment of respiratory distress syndrome and prevention of bronchopulmonary dysplasia |
| title_short | The efficacy of intra-tracheal budesonide with surfactant in treatment of respiratory distress syndrome and prevention of bronchopulmonary dysplasia |
| title_sort | efficacy of intra tracheal budesonide with surfactant in treatment of respiratory distress syndrome and prevention of bronchopulmonary dysplasia |
| topic | bronchopulmonary dysplasia budesonide premature infants respiratory distress syndrome surfactant |
| url | https://mj.tbzmed.ac.ir/PDF/mj-43-1-48.pdf |
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