Efficacy Of Intratracheal Instillation Of Budesonide Using Surfactant As A Vehicle To Treatment Respiratory Distress Syndrome Of Preterm Infants

Objective to evaluate the effect of early intratracheal instillation of surfactant and budesonide on the effectiveness,complications and prevention of BPD in preterm infants with neonatal respiratory distress syndrome(NRDS).Methods:The study recruited preterm infants with severe NRDS,the infants received ps and bud as research group,the others only recived PS as control group.the primary outcomes were Peak Inspiratory Pressure,Breathing rate,Fraction of inspiration O2;the PaO2,PA-aO2,Oxygenation index were compared before, at 24 and 48 hours after intratracheal administratio the duration of ventilation,hospital stay,complications,the incidence of BPD were also analysed.Results:1.Before and after 24 hours of intratracheal instillation,the PIP? RR?FiO2 had no significant differences between two groups(P>0.05); after 48 hours,the PIP and FiO2 showed statistically significant differences(P<0.05),repectively;there was no significant difference in RR between two groups(P>0.05).2.Before after 24 hours and 48 hours after intratracheal administration,the parameters(PaO2?PA-aO2?OI)had no significant differences between two groups(P>0.05).3.compared with the control group, the research group had significantly shorter duration of invasive respiratory support,hospital stay and rapid extubution(P<0.05).4.There were no differences observed between two groups regarding the incidence of Intraventricular Hemorrhage, Retinopathy of prematurity, pulmonary haemorrh-ge, Patent ductus arteriosus, septicemia, Necrotizing enterocolitis, ventilator associa- ted pneumonia,(P>0.05).5.The incidence of BPD was 55.6% in the research group and 67.9% in the control group,but the difference was not statistically significant(P>0.05). In addition,The incidence of moderate and severe BPD in research group significantly lower than in control group(P<0.05).Conclusion1.In infants with severe RDS,early intratracheal administration of surfactant and budesonide provides benefits of better improving oxygenation,shorter hospital stay, rapid extubation,and without increasing complications.2.Early intratracheal instillation of Budesonide and Pulmonary surfactant in the treatment of preterm infants with RDS potentially benefits the occurrence of severe BPD,but withou leading to reduce the incidence of BPD.