Prevalencia de hemorragia pulmonar asociada a la administración de surfactante pulmonar de origen bovino en prematuros extremos por factores de riesgo Materno - Infantil en el Hospital General Guasmo Sur 2021 - 2023.

Abstract

Pulmonary hemorrhage in the neonatal stage is a respiratory condition of significant severity and mortality characterized primarily by the presence of bright red blood through the endotracheal tube. It is observed in extremely premature newborns, who have high morbidity and mortality. Surfactant is a macromolecular structure composed of proteins, phospholipids, and carbohydrates, the main component of which is phosphatidylcholine. Phosphatidylcholine represents 70% of the lipids and is the main component of surfactant, which reduces surface tension. However, the most serious complication of surfactant treatment is the development of pulmonary hemorrhage. Surfactant treatment, by increasing pulmonary blood flow as PaO2 increases, with a reduction in pulmonary vascular resistance as lung function improves, worsens any existing pulmonary edema and leads to pulmonary hemorrhage. Observational studies suggest that surfactant administration after pulmonary hemorrhage may improve the neonatal oxygenation index. According to data from the Spanish Association of Pediatrics, natural surfactants have an early onset of action, making pulmonary surfactant the primary therapeutic indication. It has been shown to reduce the risk of pneumothorax, interstitial lung disease, and the need for mechanical ventilation, with more efficient clinical improvement, greater neonatal survival, and reduced economic costs. Considering the use of bovine surfactant as a therapy for RDS and the potential risks of this medication, the risk-benefit ratio of this product was investigated.