신생아 호흡곤란증후군에서 인공 폐 표면활성제 조기요법의 중요성과 필요성

The Importance and the Need of Early Pulmonary Surfactant Therapy in Premature Infant with Respiratory Distress Syndrome

  • 김성미 (부산성모병원 소아청소년과) ;
  • 윤혜선 (을지의대 노원을지병원 소아청소년과) ;
  • 김기수 (울산의대 서울아산병원 소아청소년과) ;
  • 배종우 (경희의대 동서신의학병원 소아청소년과)
  • Kim, Sung-Mi (Department of Pediatrics, Busan St. Mary's Medical Center) ;
  • Yoon, Hye-Sun (Department of Pediatrics, Eulji University School of Medicine) ;
  • Kim, Ki-Soo (Department of Pediatrics, Asan Medical Center, Ulsan University) ;
  • Bae, Chong-Woo (Department of Pediatrics, Kyunghee University East-West Medical Center)
  • 발행 : 2009.11.30

초록

Pulmonary surfactant (PS) therapy in premature infants has a remarkable impact on improving survival and outcomes in neonatal respiratory distress syndrome (RDS). Early PS therapy involves instillation of PS upon delivery of very premature infants or if there is evidence of RDS, such as an increased requirement of oxygen 2 hours after birth, especially in infants <30 weeks gestation. Early PS treatment in very premature infants results in a significant reduction in the severity of RDS, mortality, and incidence of pneumothorax, pulmonary interstitial emphysema, and bronchopulmonary dysplasia in comparison with late PS treatment. According to European and American consensus guidelines on the management of neonatal RDS, early PS instillation should be considered for infants <30 weeks gestation, infants with a birth weight <1,250 g, or if the mother has not received antepartum corticosteroids. We suggest that the Korean health insurance policy on RDS be modified so that PS can be used for better clinical outcomes of very premature infants.

키워드

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