Complications among premature neonates treated with beractant and poractant alfa
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Abstract
Objective
To compare the complications among preterm infants treated with two different natural surfactants.
Methods
In a randomized clinical trial, 150 preterm infants with Respiratory distress syndrome (RDS) treated with exogenous surfactant, were enrolled in the study. Group A consisted of 79 neonates that received poractant (curosurf). Seventy one newborn infants in group B were treated with beractant (Survanta).
Results
The mean gestational age for group A and B were 29.40±2.90 wk and 29.50±2.73 wk (P=0.82), respectively. The demographic and clinical variables were similar in both groups. The mean duration of intubation (as a primary outcome) was significantly shorter in infants treated with poractant (3.13±1.80 vs 4.06±2.7 days p=0.05). The mean duration of need for oxygen and hospitalization of patients in group A and B were 17.73±22.25 vs 19.14±17.85 days (p=0.67) and 24.89±26.41 vs 29.14±23.54 days (p= 0.32), respectively. There was no significant difference between groups with respect to mortality and morbidity, including pulmonary hemorrhage, intraventricular hemorrhage (IVH), patent ductus arteriosus, sepsis, and bronchopulmonary dysplasia (secondary outcome).
Conclusions
In this study, infants who received poractant had shorter duration of intubation than infants treated with beractant, without any difference in the duration of oxygen therapy or hospitalization. There was no significant superiority of poractant over beractant.
Key words
Poractant Respiratory distress syndrome Beractant MorbidityPreview
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References
- 1.Engle WA and committee on fetus and newborns. American academy of pediatrics. Surfactant replacement therapy for respiratory distress syndrome. Pediatrics 2008; 121: 419–432.CrossRefPubMedGoogle Scholar
- 2.Rodiguez RJ, Martin RJ, Fanaroff AA. Respiratory distress and its management. In Fanaroff AA, Martin RJ, eds. Neonatalperinatal medicine. Disease of the fetus and infant, 8th ed, Philadelphia; Mosby, 2006; 2: 1097–1107.Google Scholar
- 3.Rodiguez RJ, Martin RJ. Exogenous surfactant therapy in newborns. Respir Care Clin N Am 1999; 5: 595–616.Google Scholar
- 4.Suresh GK, Soll RF. Pharmacologic adjuncts II: exogenous surfactant. In Goldsmith JP, Karotkin EH, ed. Assisted ventilation of the neonate, 4th ed. Philadelphia; Saunders, 2003; 329-344.Google Scholar
- 5.Soll RF, Blanco F. Natural surfactant extract versus synthetic surfactant for neonatal respiratory distress syndrome. Cochrane Database Syst Rev 2001; 2: CD000144.PubMedGoogle Scholar
- 6.Stevens TP, Blennow M, Myers E, Soll R. Early surfactant administration with brief ventilation vs. selective surfactant and continued mechanical ventilation for preterm infants with or at risk for RDS. Cochrane Database Syst Rev 2002; 2: CD003063.PubMedGoogle Scholar
- 7.Ainsworth SB, Beresford MW, Milligan DWA. Pumactant and poractant alfa for treatment of respiratory distress syndrome in neonates born at 25–29 weeks’ gestation: a randomized trial. Lancet 2000; 355: 1387–1392.CrossRefPubMedGoogle Scholar
- 8.Moya FR, Gadzinowski J, Bancalari E et al. A multicenter randomized masked comparison trial of lucinactant, colfoceril palmitate and beractant for the prevention of respiratory distress syndrome in very preterm infants. Pediatrics 2005; 115: 1018–1029.CrossRefPubMedGoogle Scholar
- 9.Hammound M, Al Kazmi N, Alshemmiri M et al. randomized clinical trial comparing two natural surfactant preparations to treat respiratory distress syndrome. J Matern Fetal Neonatal Med 2004; 15: 167–175.CrossRefGoogle Scholar
- 10.Horbar JD, Carpenter JH, Buzas J et al. Collaborative quality improvement to promote evidence based surfactant for preterm infants: a cluster randomized trial. BMJ 2004; 329: 1004.CrossRefPubMedGoogle Scholar
- 11.Walti H, Paris-Liado J, Egberts J et al. Prophylactic administration of porcine-derived lung surfactant is a significant factor in reducing the odds for peri-intraventricular hemorrhage in premature infants. Biol Neonat 2002; 81: 182–187.CrossRefGoogle Scholar
- 12.Bloom BT, Katwinkel J, Hall RT et al. Comparison of infasurf (calf lung extract)to survanta (beractant)in the treatment and prevention of respiratory distress syndrome. Pediatrics 1997; 100: 31–38.CrossRefPubMedGoogle Scholar
- 13.Clark RH, Auten RL, Peabody J. A comparison of the outcomes of neonates treated with two different natural surfactants. J Pediatr 2001; 139: 828–831.CrossRefPubMedGoogle Scholar
- 14.Speer CP, Gefeller O, Groneck P et al. Randomized clinical trial of two different treatment regimens of natural surfactant preparations in neonatal respiratory distress syndrome. Arch Dis Child 1995; 72: P8–P13.Google Scholar
- 15.Baroutis G, Kaleyias J, Liarout et al. Comparison of three treatment regimens of natural surfactant preparations in neonatal respiratory distress syndrome. Eu J Pediatr 2003; 162: 476–480.CrossRefGoogle Scholar
- 16.Ramanthan R, Ramussen MR, Gerstmann D et al. For the North American study group. A randomized, multicenter masked comparison trial of proctant alfa (curosurf) versus beractant (survanta) in the treatment of respiratory distress syndrome in preterm infants. Am J Perinatol 2004; 21: 109–119.CrossRefGoogle Scholar
- 17.Lam BC, Ng YK, Wong KY. Randomized trial comparing two natural surfactants (survanta vs bLES ) for treatment of neonatal respiratory distress syndrome. Pediatr Pulmonol 2005; 39: 64–69.CrossRefPubMedGoogle Scholar
- 18.Yalaz M, Arslanolu S, Akisu M, Atik T, Ergun O, Kultursay N. A comparison of efficacy between two natural exogenous surfactant preparations in premature infants with respiratory distress syndrome. Klin Padiatr 2004; 216: 230–235.CrossRefPubMedGoogle Scholar
- 19.Sinha S, Lacaze-Masmonteil T, Valis i Soler A et al. A multicenter, randomized, controlled trial of Lucinactant versus Poractant alfa among very premature infants at high risk for respiratory distress syndrome. Pediatrics 2005; 115: 1030–1038.CrossRefPubMedGoogle Scholar
- 20.Chotigeat U, Promwong N, Kanjanapattanakul W, Khorana M, Sangtawesin V, Horpaopan S. Comparison outcomes of surfactant therapy in respiratory distress syndrome in two periods. J Med Assoc Thai 2008; 91: S109–S114.PubMedGoogle Scholar
- 21.Bncalari E, Del Moral T. Bronchopulmonary dysplasia and surfactant. Biol Neonate 2001; 80: 7–13.CrossRefGoogle Scholar