:: Volume 28, Issue 6 (Scientific Journal of Kurdistan University of Medical Sciences 2024) ::
SJKU 2024, 28(6): 48-64 Back to browse issues page
Comparison of the Consequences of Intratracheal Administration of Surfactant Plus Budesonide with Surfactant alone in Preterm Infants with Respiratory Distress Syndrome
Morteza Habibi1 , Fatemeh Toohidinia 2
1- Children Growth Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
2- Children Growth Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran. , dr.fatemetoohidnia@gmail.com
Abstract:   (677 Views)
Background and Aim: To control complications in infants with respiratory distress syndrome, surfactants and auxiliary drugs such as budesonide are used to reduce the inflammatory reactions of the airways. The aim of this study is to compare the effect of intratracheal administration of survanta and survanta with budesonide in premature infants with respiratory distress syndrome.
Materials and Methods: This clinical trial included 50 premature infants with respiratory distress syndrome, hospitalized in the neonatal intensive care unit in Qazvin Children's Hospital, in 2019. The patients were divided into two groups. One group (25 cases) received intratracheal survanta (1 milliliter) + budesonide (0.25 milligram) and the other group (25 cases) received only intratracheal survanta. Using SPSS 21 software, data were analyzed by  descriptive statistics, Fisher's exact and T-test (p<0.05).
Results: In the survanta+budesonide group, we found intraventricular hemorrhage in 50% and also death in 50% of the cases. In the pregnant women over 31 years of age and female infants receiving survanta + budesonide, no complications were seen. The effect of Survanta + budesonide compared to survanta on reducing complications in the infants (p = 0.048), in regard to the mothers' age group; 31 years and under 31 years (p = 0.049), and over 31 years of age (p = 0.046), female (p=0.047) and male (p=0.050) showed  significant differences.
Conclusion: Administering survanta with budesonide resulted in better efficacy and fewer side effects. Budesonide can be used as an adjuvant treatment. Appropriate therapeutic measures are important for the improvement and survival of the newborns with respiratory distress syndrome.
Keywords: Surfactant, Surfactant with budesonide, Premature infants, Respiratory distress syndrome
Full-Text [PDF 675 kb]   (157 Downloads)    
Type of Study: Original Research | Subject: Medicine - Pediatric
Received: 2022/05/8 | Accepted: 2023/09/5 | Published: 2024/02/6
1. Dyer J. Neonatal Respiratory Distress Syndrome: Tackling A Worldwide Problem. P T. 2019;44(1):12-14.
2. Ekhaguere OA, Okonkwo IR, Batra M, Hedstrom AB. Respiratory distress syndrome management in resource limited settings-Current evidence and opportunities in 2022. Front Pediatr. 2022;10:961509. [DOI:10.3389/fped.2022.961509] [PMID] []
3. Ettinger M. Antiviral and antibacterial actions of monolaurin and lauric acid. Mol Cell Biochem. 2005;272(1-2):29-34. [DOI:10.1007/s11010-005-6604-1] [PMID]
4. Saichek RE, Reddy KR. Electrokinetically enhanced remediation of hydrophobic organic compounds in soils: a review. Critical reviews in environmental science and technology. 2005;35(2):115-192. [DOI:10.1080/10643380590900237]
5. Vasconcelos T, Marques S, Sarmento B. The biopharmaceutical classification system of excipients. Ther Deliv. 2017;8(2):65-78. [DOI:10.4155/tde-2016-0067] [PMID]
6. Shimogaki H, Takeuchi K, Nishino T, Ohdera M, Kudo T, Ohba K, et al. Purification and properties of a novel surface-active agent-and alkaline-resistant protease from Bacillus sp. Y. Agric Biol Chem.1991;55(9):2251-2258. https://doi.org/10.1080/00021369.1991.10870947 [DOI:10.1271/bbb1961.55.2251] [PMID]
7. Lykkedegn S, Sorensen GL, Beck-Nielsen SS, Christesen HT. The impact of vitamin D on fetal and neonatal lung maturation. a systematic review. Am J Physiol Lung Cell. Mol. 2015;308(7):L587-602. [DOI:10.1152/ajplung.00117.2014] [PMID]
8. Tsao K, Hawgood S, Vu L, Hirose S, Sydorak R, Albanese CT, Farmer DL, Harrison MR, Lee H. Resolution of hydrops fetalis in congenital cystic adenomatoid malformation after prenatal steroid therapy. J Pediatr Surg. 2003;38(3):508-510. [DOI:10.1053/jpsu.2003.50089] [PMID]
9. Enhorning G, Shennan A, Possmayer F, Dunn M, Chen CP, Milligan J. Prevention of neonatal respiratory distress syndrome by tracheal instillation of surfactant: a randomized clinical trial. Pediatrics. 1985;76(2):145-153. [DOI:10.1542/peds.76.2.145] [PMID]
10. Szefler SJ. Pharmacodynamics and pharmacokinetics of budesonide: a new nebulized corticosteroid. Journal of allergy and clinical immunology. 1999;104(4):S175-83. [DOI:10.1016/S0091-6749(99)70059-X] [PMID]
11. Van Hoogevest P, Wendel A. The use of natural and synthetic phospholipids as pharmaceutical excipients. Eur J Lipid Sci Technol. 2014;116(9):1088-1107. [DOI:10.1002/ejlt.201400219] [PMID] []
12. Sadeghnia A, Tanhaei M, Mohammadizadeh M, Nemati M. A comparison of surfactant administration through i-gel and ET-tube in the treatment of respiratory distress syndrome in newborns weighing more than 2000 grams. Adv Biomed Res. 2014;3:160. [DOI:10.4103/2277-9175.137875] [PMID] []
13. Hamvas A. Martin RJ, Fanaroff AA, Walsh MC. Fanaroff and Martin's Neonatal- Perinatal Medicine. 9th ed. St. Louis: Elsevier Mosby; 2011. Pathophysiology and management of respiratory distress syndrome; pp. 1106-1111. [DOI:10.1016/B978-0-323-06545-0.00053-4]
14. Pan J, Chen MW, Ni WQ, Fang T, Zhang H, Chen Y, et al. Clinical efficacy of pulmonary surfactant combined with budesonide for preventing bronchopulmonary dysplasia in very low birth weight infants. Zhongguo Dang Dai Er Ke Za Zhi. 2017;19(2):137-141.
15. Berggren E, Liljedahl M, Winbladh B, Andreasson B, Curstedt T, Robertson B, et al. Pilot study of nebulized surfactant therapy for neonatal respiratory distress syndrome. Acta Paediatr. 2000;89:460-464. [DOI:10.1111/j.1651-2227.2000.tb00084.x] [PMID]
16. Yeh TF, Chen CM, Wu SY, Husan Z, Li TC, Hsieh WS, et al. Intratracheal administration of budesonide/surfactant to prevent bronchopulmonary dysplasia. Am J Respir Crit Care Med. 2016;193(1):86-95. [DOI:10.1164/rccm.201505-0861OC] [PMID]
17. Jónsson B1, Eriksson M, Söder O, Broberger U, Lagercrantz H. Budesonide delivered by dosimetric jet nebulization to preterm very low birthweight infants at high risk for development of chronic lung disease. Acta Paediatr. 2000;89:1449-55. [DOI:10.1111/j.1651-2227.2000.tb02775.x]
18. Moschino L, Nardo D, Bonadies L, Stocchero M, Res G, Priante E, et al. Intra-tracheal surfactant/budesonide versus surfactant alone: Comparison of two consecutive cohorts of extremely preterm infants. Pediatr Pulmonol. 2021;56(7):2114-24. [DOI:10.1002/ppul.25415] [PMID] []
19. Tang W, Chen S, Shi D, Ai T, Zhang L, Huang Y, et al. Effectiveness and safety of early combined utilization of budesonide and surfactant by airway for bronchopulmonary dysplasia prevention in premature infants with RDS: A meta-analysis. Pediatr Pulmonol. 2022;57(2):455-69. [DOI:10.1002/ppul.25759] [PMID]

Ethics code: IR.QUMS.REC.1399.386
Clinical trials code: IRCT20210412050944N1

XML   Persian Abstract   Print

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Volume 28, Issue 6 (Scientific Journal of Kurdistan University of Medical Sciences 2024) Back to browse issues page