Hyaline membrane disease (HMD) therapy in Latin America: Impact of exogenous surfactant administration on newborn survival, morbidity and use of resources

Jose Diaz Rossello, Paul Estol Hayward, Miguel Martell, Mario Del Barco, Paulo Margotto, Jose Grandzoto, Jaime Bastida, Jose Peña, Dina Villanueva

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Impact of surfactant administration, on neonatal mortality, morbidity and resource use, was assayed in a historically controlled study in 19 NICUs from 5 Latin American countries. Data from clinical records of infants with HMD were retrospectively reviewed for the previous 2 years (PRE phase n = 666 cases), and prospectively in cases that received surfactant (SURF phase, 348 cases). Birth weight stratified relative risk, with 95% confidence interval (RR ± 95% CI) for death, in the SURF as compared to the PRE was 0.60 (0.49-0.74), 0.79 (0.68-0.92) and 0.82 (0.71-0.94), for days 7, 28 and at discharge, respectively. At all ages mortality was significantly lower during SURF. Significant increases were observed in the occurrence of pulmonary interstitial emphysema, pulmonary hemorrhage, patent ductus arteriosus, bronchopulmonary dysplasia, intrahospital infection and necrotizing enterocolitis. Resource use increased significantly. It is concluded that the use of surfactant in the region is an important advance, and the efficacy of management of the late complications of the very premature and labile HMD survivors must increase. More attention should be given to thermal regulation, nutrition and management of infection in the survivors, before a more marked effect of surfactant can be seen.

Original languageEnglish (US)
Pages (from-to)280-287
Number of pages8
JournalJournal of Perinatal Medicine
Volume25
Issue number3
StatePublished - Aug 19 1997
Externally publishedYes

Keywords

  • Hyaline membrane disease
  • Latin America
  • Newborn
  • Pulmonary surfactants

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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    Rossello, J. D., Hayward, P. E., Martell, M., Del Barco, M., Margotto, P., Grandzoto, J., Bastida, J., Peña, J., & Villanueva, D. (1997). Hyaline membrane disease (HMD) therapy in Latin America: Impact of exogenous surfactant administration on newborn survival, morbidity and use of resources. Journal of Perinatal Medicine, 25(3), 280-287.