Abstract

Context: Respiratory Distress Syndrome (RDS) is a significant cause of morbidity and mortality in preterm neonates due to pulmonary immaturity and lack of endogenous surfactant. This study evaluates the effect of early and prophylactic surfactant therapy in preterm neonates in a tertiary care setting. Aims: To assess the clinical outcomes of early and prophylactic surfactant therapy in preterm neonates. Settings and Design: A prospective observational clinical trial conducted over 24 months at the Neonatal Intensive Care Unit (NICU) of VMGMC Solapur. Methods and Material: The study included preterm neonates up to 28 days old who received surfactant therapy. Neonates with severe congenital anomalies were excluded. Surfactant was administered using the Intubation-surfactant-Extubation (InSurE) technique without sedation. Bovine lipid extract surfactant (NEOSURF) was administered, followed by non-invasive positive pressure ventilation (NIPPV). Data was collected using a pre-designed questionnaire and analysed using IBM SPSS version 21.0. Statistical analysis used: Descriptive statistics was used to describe the data. Chisquare test was applied for qualitative data, and Student's t-test for quantitative data. A pvalue of <0.05 was considered statistically significant. Results: Out of 97 neonates, 67.01% had a gestational age of 28-32 weeks, and 62.88% had low birth weight. Clinical presentations included nasal flaring (97.93%) and grunting (63.91%). The majority of surfactant administrations occurred within the first 6 hours (53.6%). Postsurfactant, arterial blood gas normalization was achieved in 88% of the cases. Complications included acute desaturation (12.37%) and apnea (12.37%). Mortality was 10.67%, with the majority being discharged after an average NICU stay of 17.6 days. Conclusions: Early and prophylactic surfactant therapy significantly improved clinical outcomes in preterm neonates, reducing morbidity and mortality with manageable complications.

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