1443 IS ULTRA EARLY (UE) SURFACTANT (S-TA) TREATMENT IN HYALINE MEMBRANE DISEASE (HMD) BENEFICIAL?

Abstract

Although S-TA has been used in the treatment of HMD, the optimal time of therapy is not established. We compared the physiologic responses to ultra early (UE) and late (LT) treatment of S-TA therapy in preterm baboons (76% of term). After C-section they were intubated and ventilated. S-TA 100 mg/kg was instilled at 10' in UE group and at 2 hrs. in LT group. All were treated to maintain normoxia, normocarbia, and normal pH range. Sequential data are shown below. Improvement in compliance (CL) was significantly better in UE than LT group. Mean airway pressure (MAP) dropped significantly in UE group reaching 5.2±2.2 cmH₂0 at 14 hrs. P-V curves of lungs at autopsy showed significantly higher lung vol. (at P5 deflation, 19.3±5.2 vs 11.6±2.8 ml/kg. P<.02) in UE group. These data suggest UE treatment establishes rapid alveolar stability and improves lung compliance facilitating rapid drop in MAP. better than the late treated group.

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