Respiratory distress syndrome (RDS) is a common cause of mortality and complications in the preterm neonates. Specific treatment of this disease is endotracheal surfactant administration. Some neonates need more than one dose of drug (re-dosing) so that in addition to the cost, avoidace of treatment complications and, if necessary, timely prescribtion are of high importance. In this study, the effects of the contributing factors, including prescription or non-prescription of corticosteroid to the mother, the gestational age, fetal gender, birth weight, the first and fifth minute APGAR score, respiratory distress score, time of first dose of surfactant administration, type of delivery, type of surfactant, in the case of re-dosing of surfactant in neonates with RDS, and in NICU of Motahari Maternity-Children Hospital, Urmia, Iran were compared and the positive and negative effects of each of the above-mentioned factors were examined. Few studies have been conducted on the effect of the administration of the second dose of surfactant and its subsequent doses compared with the used doses. All hospitalized neonates, who were diagnosed with RDS after birth during 2011 to 2013, were included in the study. Data was collected from a designed form and analyzed by SPSS version 22. They included 213 (60.9%) male and 137 (39.1%) females with a mean weight of 1782.03 ± 387.04 g. 66 males (31%) and 32 females (23.4%) received more than one dose of surfactant. 227 neonates (64.9%) were discharged with a recovery and 123 neonates (35.1%) died. Findings of our study showed that neonates with the low birth weight have received more than one dose of surfactant. Moreover, neonates born between 32 to 36 weeks of gestation needed re-dosing of more surfactant. Neonates with first dose of surfactant for 6 to 24 h after birth need significantly more re-dosing of surfactant. There was a significant difference between the re-dosing of surfactant and type of delivery. In addition, re-dosing of more surfactant was needed with the increasing numbers of neonate per delivery. In contrast; the need to re-dosing of surfactant in the neoantes whose mothers had received one dose of prenatal corticosteroid was greater than the neoantes whose mothers had received two doses of prenatal corticosteroid. Moreover, the type of the surfactant products (curosurf and Survanta) had no effect on the re-dosing of doses of surfactant in the studied infants. The percentage of the use of more than one dose of surfactant was higher in male neonates than the female ones. Inaddition, the first and fifth minute APGAR scores were significantly lower in re-dosing group. In this study, the need for re-dosing of surfactant was significantly greater in the neonates with the higher respiratory distress score (>8) than the neonates with the mild to moderate respiratory distress scores (≤8).
Key words: Respiratory distress syndrome, surfactant, re-dosing.