Mehmet YALAZ, Nilgün KÜLTÜRSAY, Özgün UYGUR

Yenidoğan döneminde sürfaktan kullanımı-bilinenler, halen araştırılanlar, araştırılması gerekenler

Sıkıntılı solunum sendromu sürfaktan eksikliğinin doğal sonucu olarak gelişen akciğer yetersizlik tablosudur ve erken doğan bebeklerde hastalık ve ölümün temel nedenidir. Son kılavuzlara göre erken doğum için risk taşıyan anneler sıkıntılı solunum sendromu konusunda deneyimli mer- kezlere yönlendirilmeli ve 34 haftanın altındaki tüm gebelere erken do- ğum eylemi söz konusu ise doğum öncesi kortikosteroid uygulanmalıdır. Bebekte sıkıntılı solunum sendromu hastalığı ve riski bulunması halinde sürfaktan tedavisi uygulanmalı ve 26 haftanın altındaki tüm bebeklere doğum odasında koruyucu sürfaktan uygulanmalıdır. Koruyucu tedavi haftasına bakılmaksızın devamlılık için entübasyon gereksinimi olan tüm sıkıntılı solunum sendromlu erken doğmuş bebeklere verilmelidir. Doğum öncesi steroid tedavisi tamamlanmış, doğum odasında sıkıntılı solunum sendromu nedeniyle entübasyon gerekmeyen olgulara burun- dan kontinu pozitif hava yolu basıncı uygulaması başlatılır ve izleminde entübasyon gerektirirse erken kurtarma tedavisi uygulanabilir. Sürfak- tan kullanımında doğal sürfaktan şekli tercih edilmelidir. Bebek stabilse sürfaktan uygulaması sonrası erken ekstübasyon ile girişimsel olmayan solunum desteğine geçilmeye çalışılmalıdır. Bu derlemede sürfaktan te- davisi ile ilgili sorulara yanıt aramaya çalışan güncel çalışmaların yeni verileri tartışılacaktır. (Türk Ped Arş 2014; 49: 1-12)

The use of surfactant in the neonatal period- the known, those still under research and those need to be further investigated

Respiratory distress syndrome is pulmoner insufficiency caused by the lack of surfactant and the main reason of morbidity and mortality in pre- term infants. Mothers at high risk of preterm birth should be transferred to perinatal centers with experience for respiratory distress syndrome and antenatal steroids should be given before 35 weeks of gestational age. Surfactant treatment should be applied to babies with or at high risk for respiratory distress syndrome. Prophylaxis should be given to infants of

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