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Therapeutic efficacy of surfactant supplementation after pulmonary hemorrhage in improving clinical outcomes of preterm infants with gestational age <34 weeks
Received date: 2025-02-19
Accepted date: 2025-07-07
Online published: 2025-08-27
Objective Whether exogenous pulmonary surfactant (PS) administration could prolong the survival time of preterm infants after pulmonary hemorrhage is currently a lack of sufficient evidence. This study was conducted to evaluate the effect of surfactant administration after pulmonary hemorrhage on the survival prognosis of preterm infants. Methods The study participants were preterm babies, gestational age (GA) <34 weeks, with pulmonary hemorrhage admitted from January 1, 2017 to December 31, 2022. After pulmonary hemorrhage, infants would be given an additional dose of PS if the parents agreed. The timing of administration is usually 2-4 hours after the pulmonary hemorrhage stabilizes. Accordingly, the participants were retrospectively divided into the PS administration group after pulmonary hemorrhage (n=16) and the non-PS administration group after pulmonary hemorrhage (n=40) according to the records from hospital information system. Results It was found that the blood gas was better after PS administration. Moreover, the survival time, duration of caffeine administration, and duration of invasive ventilation were significantly longer in the PS administration group (P<0.05). The intergroup comparison showed that the application of PS after pulmonary hemorrhage could reduce the short-term all-cause mortality within 72 hours and 168 hours (P<0.05), but for the all-cause mortality within 702 hours and during the complete hospitalization period, there was no significant difference between the two groups. The Log-rank test of the survival curve showed that the application of PS after pulmonary hemorrhage could reduce the risk of death within 72 hours, within 168 hours, and during the full hospitalization period (P<0.05), except for the risk of death within 702 hours. The Breslow test showed that the application of PS after pulmonary hemorrhage could significantly prolong the survival time from 72 hours after pulmonary hemorrhage to discharge (P<0.05). Conclusion Administering PS to preterm infants with gestational age <34 weeks after pulmonary hemorrhage may have potential benefits, further clinical studies are needed to explore whether this treatment can improve the long-term outcomes.
LIU Yun , PAN Jingjing , SHEN Jinxin , ZOU Yunsu , CHENG Rui , FENG Yun , YANG Yang . Therapeutic efficacy of surfactant supplementation after pulmonary hemorrhage in improving clinical outcomes of preterm infants with gestational age <34 weeks[J]. Journal of Clinical Pediatrics, 2025 , 43(9) : 652 -660 . DOI: 10.12372/jcp.2025.25e0126
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