Endobronchial surfactant administration in full-term newborn with respiratory distress syndrome

Neonatal respiratory distress syndrome is the leading cause of neonatal acute respiratory failure. Despite the successes achieved and the existing international recommendations, in some cases there is a severe course of this disease, which requires a personalized approach to the patient and intensive care measures. The article presents a case of successful treatment of acute respiratory distress syndrome in a full-term newborn complicated by pulmonary barotrauma using monobronchial administration of exogenous surfactant under X-ray control. In order to assess the course of the disease and the effectiveness of treatment, a retrospective analysis of medical documentation was carried out. From the first minutes of life, the child had respiratory disorders, which was the basis for non-invasive mechanical lung ventilation — nCPAP (nasal continuous positive airway pressure). Progression of hypercapnia and hypoxemia was revealed over time, and therefore tracheal intubation was performed and convective mechanical ventilation was started with FiO₂ = 1,0. Monobronchial administration of exogenous surfactant was a key element of the therapy that allowed to achieve stabilization of the condition and regression of gas exchange disorders with complete recovery of the patient. Monobronchial administration of surfactant in acute respiratory distress syndrome with heterogeneous lung involvement is an effective treatment option and can be used in clinical practice for refractory hypoxemia.