IRCT201205213512N2 IRCT 2012-06-18 Mazandaran University of Medical Siences The effect of the use of surfactant administration during NCPAP treatment on complications of RDS Comparison of the effect of surfactant administration during NCPAP with NCPAP alone on mortality ,morbidity and complications of RDS in premature neonates 2011-03-21 anticipated 60 Complete https://irct.ir/trial/3617 interventional Randomization: Randomized, Blinding: Not blinded, Placebo: Not used, Assignment: Parallel, Purpose: Treatment. N/A Respiratory Distress Syndrome in the newborn. Intervention 1: In control group nasal CPAP of 6 cm H2O is administered for the patients and the infant remains on NCPAP.Any patient who needs mechanical ventilation (according to criteria below) is intubated and placed under intermittent mandatory ventilation (IMV) and is considered as nCPAP failure in control group. If needed Fio2 is more than 30% the resque dose of surfactant (Survanta ) is administered. Additional surfactant doses are given every 6 hours as long as Fio2 remains more than 30% but not after 48 hours of age. Intervention 2: In the treatment group the patient is placed on nCPAP and then temporarily intubated. A natural surfactant (Survanta , Abbot Laboratories, Abbot Park, IL) 100 mg/Kg is administered intratrachealy and the neonate is ventilated manually with Neopuff infant resuscitator (Fisher & Paykel Healthcare, Inc, Auckland, New Zealand) with peak inspiratory pressure of 20 cm H2O and positive-end expiratory pressure of 5 cm H2O only for some minutes and if the patient is stable extubation to NCPAP of 5 cm H2O is accomplished. Every patient on CPAP would receive Aminophylline with a loading dose of 5 mg/Kg and then 1 mg/Kg every 8 hour intravenously. Any patient who needs mechanical ventilation is intubated and placed under intermittent mandatory ventilation (IMV) and is considered as INSURE failure in treatment group . If needed Fio2 is more than 30% the resque dose of surfactant (Survanta ) is administered. Additional surfactant doses are given every 6 hours as long as Fio2 remains more than 30% but not after 48 hours of age.