Academy of Medical Sciences of I.R. Iran Archives of Iranian Medicine 1029-2977 27 10 2024 10 01 Endotracheal Surfactant and Budesonide Combination Therapy in Neonatal Acute Respiratory Distress Syndrome due to Late-Onset Sepsis 573 579 10.34172/aim.31725 EN Asli Okbay Gunes https://orcid.org/0000-0003-4041-0648 Aydin Bozkaya https://orcid.org/0000-0001-8800-2753 Journal Article 10.34172/aim.31725 2024 07 16 2024 09 11 Background: Neonatal acute respiratory distress syndrome (NARDS) is an important cause of hypoxemic respiratory failure. This study aimed to investigate the short-term effects of endotracheal surfactant and budesonide combination therapy on NARDS secondary to late-onset neonatal sepsis (LONS). Methods: This was a retrospective, cross-sectional, and observational study. Newborns with NARDS due to LONS who received endotracheal surfactant and budesonide combination therapy between August 2022 and September 2023 were included in this study. Oxygenation status before endotracheal surfactant and budesonide treatment were compared with the values obtained two hours after treatment. Results: Among 20 neonates, 10 (50%) were diagnosed with severe NARDS, and 10 (50%) were diagnosed with moderate NARDS. The mean corrected gestational age was 33.3±2.9 w when endotracheal surfactant and budesonide were administered to the neonates. The need for the fraction of inspired oxygen (0.75 [0.57-1.00]% vs. 0.55 [0.44-0.80]%; mean difference [MD]: 17.50%, 95% confidence interval [CI]: 14.99 to 22.50) and oxygen saturation index (OSI; 8.03 [4.98-13.94] vs. 4.71 [4.11-8.93]; MD: 2.23, 95% CI: 1.22 to 3.24) decreased (P=0.001 and P<0.001, respectively) after endotracheal surfactant and budesonide treatment. However, preductal oxygen saturation (SpO2 ; 93 [91-94]% vs. 95 [94-96]%; MD: -3.50%, 95% CI: -5.00 to -2.00) increased significantly after endotracheal surfactant and budesonide treatment when compared to pre-treatment values (P<0.001). Conclusion: The reduction in oxygen demand and OSI, along with an increase in SpO2 after treatment compared to pre-treatment values, suggests that endotracheal surfactant and budesonide combination therapy could be an effective option to improve oxygenation in NARDS secondary to LONS.