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Duan X, Li J, Chen L, Shi Y, Chen X, Xue T, Liu C, Wang X, Qiu Q, Yu Z, Qiang B, Wu H, Wu T, Zhang L, Chen Z, Jigme D, Xu A, Mima Z, Da Z, Ren M, Gesang D, Pubu Z, Li C, Lv Y, Zhou H, Zhang X, Dawa Z, Gongjue W, Wang L, Wu L, Li X. Surfactant Therapy for Respiratory Distress Syndrome in High- and Ultra-High-Altitude Settings. Front Pediatr 2022; 10:777360. [PMID: 35311054 PMCID: PMC8930851 DOI: 10.3389/fped.2022.777360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 01/03/2022] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE The objective of this study is to investigate the therapeutic effect of surfactant replacement therapy (SRT) on respiratory distress syndrome (RDS) in premature infants in the Qinghai-Tibet Plateau. MATERIALS AND METHODS This multi-center retrospective cohort study collected and screened reasonable clinical data of 337 premature infants with RDS from 10 hospitals in the Qinghai-Tibet Plateau from 2015 to 2017. We grouped the cases by rationally analyzing their baseline characteristics, using logistic analysis to evaluate each factor's effect on the prognosis of the infants, and comparing the short-term improvement in blood gas and mortality after SRT treatment at different altitudes, in high-altitude (1,500-3,500 m) and ultra-high-altitude (3,500-5,500 m) groups. RESULTS Independent of altitude, the mortality rate of children with RDS in the SRT group was significantly lower than that of children in the non-SRT group (both P < 0.05). The effect of SRT on preterm infants with RDS in the high-altitude group [odds ratio (OR) = 0.44, 95% confidence interval (CI) = 0.22-0.87, P = 0.02] was better than that in the infants in the ultra-high-altitude group (OR = 0.26, 95% CI = 0.13-0.58, P < 0.01), with death rates of 34.34 and 49.71%, respectively. Similarly, after SRT, the improvement of PaO2/FiO2 and pH of children at high altitude was significantly better than those of children at ultra-high altitude (all P < 0.01). CONCLUSIONS SRT plays a prominent role in curing infants with RDS in both high- and ultra-high-altitude regions, although with better effects at high rather than ultra-high altitude. This study provides a basis for further large-scale studies on SRT for RDS treatment at high altitudes.
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Affiliation(s)
- Xudong Duan
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China.,Plateau Medical Research Center of China Medical University, Shenyang, China
| | - Jiujun Li
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China.,Plateau Medical Research Center of China Medical University, Shenyang, China
| | - Long Chen
- Department of Neonatology, Children's Hospital Affiliated Chongqing Medical University, Chongqing, China
| | - Yuan Shi
- Department of Neonatology, Children's Hospital Affiliated Chongqing Medical University, Chongqing, China
| | - Xianyang Chen
- BaoFeng Key Laboratory of Genetics and Metabolism, Beijing, China.,Zhongguancun Biological and Medical Big Data Center, Beijing, China
| | - Teng Xue
- Zhongguancun Biological and Medical Big Data Center, Beijing, China.,Zhongyuanborui (Hengqin, Zhuhai) Key Laboratory of Genetics and Metabolism, Zhuhai, China
| | - Chongde Liu
- Department of Neonatology, Qinghai Women and Children's Hospital, Xining, China
| | - Xiaorong Wang
- Department of Neonatology, Qinghai Women and Children's Hospital, Xining, China
| | - Quanfang Qiu
- Department of Pediatrics, Lhasa People's Hospital, Lhasa, China
| | - Zhen Yu
- Department of Pediatrics, Lhasa People's Hospital, Lhasa, China
| | - Bacuozhen Qiang
- Department of Pediatrics, Lhasa People's Hospital, Lhasa, China
| | - Hong Wu
- Department of Pediatrics, People's Hospital of Tibet, Tibet, China
| | - Tianqi Wu
- Department of Pediatrics, People's Hospital of Tibet, Tibet, China
| | - Lihong Zhang
- Department of Pediatrics, Linzhi People's Hospital, Tibet, China
| | - Zhangsheng Chen
- Center of Pediatrics, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Dobje Jigme
- Department of Pediatrics, Naqu People's Hospital, Tibet, China
| | - Aili Xu
- Department of Pediatrics, Shigatse People's Hospital, Tibet, China
| | - Zhuoga Mima
- Department of Pediatrics, Shigatse People's Hospital, Tibet, China
| | - Zhen Da
- Department of Pediatrics, Second People's Hospital of Tibet, Tibet, China
| | - Min Ren
- Department of Pediatrics, Second People's Hospital of Tibet, Tibet, China
| | - Deji Gesang
- Department of Pediatrics, Shannan People's Hospital, Tibet, China
| | - Zhaxi Pubu
- Department of Pediatrics, Shannan People's Hospital, Tibet, China
| | - Chun Li
- Department of Pediatrics, Changdu People's Hospital, Tibet, China
| | - Yanchao Lv
- Department of Pediatrics, Changdu People's Hospital, Tibet, China
| | - Haoquan Zhou
- Department of Pediatrics, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China.,Division of Life Science and Medicine, University of Science and Technology of China, Hefei, China
| | - Xue Zhang
- Department of Pediatrics, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China.,Division of Life Science and Medicine, University of Science and Technology of China, Hefei, China
| | - Zhuoma Dawa
- Department of Pediatrics, People's Hospital of Ali District, Tibet, China
| | - Wujin Gongjue
- Department of Pediatrics, People's Hospital of Ali District, Tibet, China
| | - Li Wang
- Department of Pediatrics, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Li Wu
- Department of Pediatrics, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Xuelian Li
- Department of Pediatrics, Daping Hospital, Third Military Medical University, Chongqing, China
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