Improved outcomes following the introduction of surfactant to an Australian neonatal unit

Objective: To study the impact of the introduction of artificial surfactant therapy for hyaline membrane disease (HMD) in an Australian neonatal intensive care unit Methodology: Infants <32 weeks gestation admitted between June 1991 and Dec 1993 who received treatment with artificial surfactant were compared with infants admitted during the preceding 30 months who would have been candidates for such treatment. Results: For treated infants with gestations in the range 24-27 weeks, there was a significant reduction in neonatal death (adjusted odds ratio 0.28) and a significant increase in the incidence of chronic lung disease (GLD) (adjusted odds ratio 3.4). With gestations in the range 28-31 weeks, there was no significant change in neonatal death or CLD, but there was a significant reduction in incidence of pneumothorax (adjusted odds ratio 0.32). Conclusions: A reduced incidence of pneumothorax and neonatal death following the introduction of artificial surfactant therapy was readily demonstrable in the Australian setting.