M. Irani Estyar - Bs. Student of Nursing, Tehran University of Medical Sciences, Tehran, Iran
M. Malekian - Bs. Student of Midwifery, Tehran University of Medical Sciences, Tehran, Iran
M. E. Heidari - Bs. Student of Nursing, Tehran University of Medical Sciences, Tehran, Iran

Background and Objective: Respiratory distress syndrome (RDS) is one of the most problems in preterm infants. Surfactant replacement therapy (SRT) has become standardtherapy in preterm infants in the past few decades. There is now convincing evidence that the severity of neonatal respiratory distress syndrome can be reduced by surfactantreplacement therapy. So, the aim of this review is to evaluate the efficacy and safety of surfactant replacement therapy in respiratory distress syndrome in preterm infants. Materials and Methods: A literature search was performed in the EMBASE, WEB of SCIENCE, MEDLINE and PUBMED in order to identify studies evaluating interventionswhich evaluate the efficacy and safety of surfactant replacement therapy in respiratory distress syndrome in preterm infants. The references in relevant reviews and published clinical trials were included in the study. Findings: The studies demonstrated that most infants can tolerate the administration of surfactant well, with the majority experiencing only small transient fluctuations in their oxygen saturation as measured by pulse oximetry. There was a rapid improvement in oxygenation as a result of an increase in arterial to alveolar oxygen tension ratio within 5 minutes after surfactant instillation. Mean airway pressure and peak inspiratory pressure also reduced significantly during the first 6 hours after surfactant therapy. No major changes in heart rate and blood pressure were observed during and after the administration of surfactant. Within the few hours after surfactant instillation, infants who received surfactant showed significant improvements in all ventilatory parameters (a/A ratio, FiO mean airway pressure and ventilatory index) and had a lower mortality rate. These improvements remained significant for 2 to 4 days after surfactant therapy. Also treating with surfactant had a decreased incidence of pulmonary interstitial emphysema and pneumothorax. Conclusion: Treatment with surfactant at birth of premature infants at high risk for respiratory distress syndrome appears to be safe and effectively improve lung function and short-term outcome in infants with severe respiratory distress syndrome.

Efficacy, Safety, Surfactant Replacement Therapy, Respiratory Distress Syndrome, Preterm Infants