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ECONOMICAL EFFECTS OF SURFACTANT TREATMENT

1994; Springer Nature; Volume: 35; Issue: 2 Linguagem: Inglês

10.1203/00006450-199402000-00157

1530-0447

Martti Virtanen, Sonja Kuhlefelt, Päivi Mäkelä‐Bengs, Anna‐Liisa Järvenpää,

Infant Development and Preterm Care

The effect of surfactants in treatment of neonatal RDS is well known. However, the favourable results increase the demand for neonatal intesive care. We collected retrospectively clinical and follow-up data of all 29 very low birthweight (VLBW) infants who received surfactant in the OSIRIS-study (from March 1991 to November 1991) and of 30 VLBW patients born during the previous year who did not receive surfactant treatment. Patients were eligible to the control group if they had at least once arterial/alveolar oxygen ratio <0.22. The gestational age, birthweight and blood pressure, were similar in both groups. Only 6 inlants in the control group survived and only 2 of them did not have any neurological sequelae. In the OSIRIS group 20 survived. 9 without neurological complications. The mean duration of neonatal intensive care was 102 days in the controll group and 26.8 days In the OSIRIS group. The mean duration of neonatal intensive care of the survivors was 32 days in both groups. A similar effect was observed on the time on respirator, and on the duration of oxygen therapy and ot hospital care. The costs of neonatal intensive care were in 1992 about 1500 US$ and the cost for care on a paediatric ward were about 400 US$ per day. Thus giving a VLBW infant surfactant will increase the costs with at least 36 000 US$. The costs per survivor were without surfactant about 3110 US$ and with surfactant 2730 US$. The costs per healthy survivor were 9330 US$ and 6670 US$, respectively. This study illustrates the economical problems associated with improvments of neonatal intensive care. Although the price per survivor decreases the increase of total costs is very large. The price of surfactant itself is almost negligible.