Effect of pulmonary surfactant combined with mechanical ventilation on oxygenation functions and expressions of serum transforming growth factor-beta1 (TGF-β1) and bone morphogenetic protein 7 (BMP-7) of neonatal respiratory distress syndrome.

OBJECTIVE: To investigate and discuss the effect of early treatment with pulmonary surfactant (PS) on oxygenation functions in neonates with acute respiratory distress syndrome (ARDS), to understand the expression trend of serum transforming growth factor-beta 1 (TGF-β1) and bone morphogenetic protein 7 (BMP-7) in children with neonatal respiratory distress syndrome (NRDS), and to provide help for early prevention and treatment of NRDS.

PATIENTS AND METHODS: All the children were treated with mechanical ventilation; among them, 25 NRDS children who were given PS within 12 h after birth were selected as PS group, and 25 NRDS children who were never given PS were selected as conventional mechanical ventilation (CMV) group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the expressions of serum TGF-β1 and BMP-7 in the two groups of children and monitor their oxygenation function indexes in 0, 1, 3, and 7 d after birth, respectively.

RESULTS: The content of serum TGF-β1 and BMP-7 in children of both PS group and CMV group trended to be higher at 1 d after birth while it was decreased at 7 d after birth compared with that in other days. The TGF-β1 content at 3 and 7 d after birth and the BMP-7 expression level at 7 d after birth in CMV group were significantly higher than those in PS group (p<0.05). After treatment, the values of oxygenation index (OI) and respiratory index (RI) at different time points (6, 12, 24, 48 h) in PS group were lower than those in CMV group (p<0.05). The mechanical ventilation duration in PS group (81±25 h) was decreased compared with that in CMV group (102±24 h); the oxygenation time in PS group (99±37 h) was less than that in CMV group (122±28 h); the number of cases of complications in PS group and CMV group was 3 (12%) and 6 (24%), respectively, and the effective rates of treatment were 96.0% and 84.0%, respectively (p<0.05).

CONCLUSIONS: Early application of PS combined with mechanical ventilation can remarkably improve lung oxygenation and compliance, suppress inflammatory responses, and effectively treat the NRDS. Monitoring the changes of serum BMP-7 and TGF-β1 is very important for treatment and prognosis assessment of the NRDS.