Objective      To investigate the difference of clinical efficacy in treatment of neonatal respiratory distress syndrome (NRDS) with different initial doses of pulmonary surfactant (PS).       Methods      Prospective multi-center controlled clinical trials and multi-stage stratified random sampling were employed

and 143 cases of NRDS

treated with PS from 3 NICUs were enrolled in the trails. The neonates were randomly divided into 2 groups

which were treated with initial dose of PS at 70 mg/kg (PS

70

) and at 100 mg/kg (PS

100

)

respectively. Blood gas analysis

chest X-ray results

repeated use of PS

complication occurrence

duration of mechanical ventilation

oxygen therapy and hospitalization were analyzed.       Results      The data demonstrated that PaO

2

PaCO

2

and chest X-ray results were improved in both groups after PS treatment (P0.05). PS

100

group had lower oxygen demand (P0.05) at 12

24 h and 36 h after PS administration compared with PS

70

group

and PO

2

and PCO

2

were improved more significantly in PS

100

group (P0.05). PS

100

group showed significantly improved chest X-ray results at 24 h after PS administration compared with PS

70

group (P0.05). Duration of mechanical ventilation and oxygen therapy were reduced more in PS

100

group than in PS

70

group (P0.05).       Conclusion      PS exerts better clinical efficacy in NRDS at the initial dose of 100 mg/kg than at 70 mg/kg.