Simultaneous intratracheal administration of surfactant and budesonide in the prevention of bronchopulmonary dysplasia in the treatment of respiratory distress syndrome in premature infants

Background: Premature birth is an important issue in developing and developed countries. The purpose of this study is to investigate the effect of budesonide and surfactant in the treatment of respiratory distress syndrome and the prevention of bronchopulmonary dysplasia (BPD).Methods: In a randomized clinical trial study, 296 premature babies with a gestational age of less than 37 weeks and weigh below 1500 grams admitted to Shahid Akbarabadi Hospital in Tehran (Iran) who were hospitalized with a diagnosis of respiratory distress syndrome and needed treatment with surfactant were included in the study. In one group (surfactant), 4 cc/kg surfactant (Braksurf) was injected intratracheally, and in the other group (surfactant + budesonide), in addition to surfactant (Braksurf), 0.25 mg/kg of budesonide was prescribed along with intratracheal surfactant. Descriptive statistics including Kaplan-Meier, Chi-square test and t-Student test were used for data analysis.Result: In infants who were administered budesonide with surfactant through a tracheal tube, the duration of mechanical ventilation, the duration of high-flow nasal cannula (HFNC), continuous positive airway pressure (CPAP) and the need to receive peripheral equipment or through channel The nose was significantly less than the babies who received only surfactant. In the surfactant group, 13 infants (8.7%) and in the surfactant + budesonide group, 4 infants (2.7%) had bronchopulmonary dysplasia.Conclusion: The use of the combination of surfactant (Braksurf) with budesonide compared to surfactant alone in the treatment of premature infants significantly reduced the need for respiratory support and the need for intubation and duration of hospitalization and bronchopulmonary dysplasia.