title: Increased survival in low birth weight neonates given prophylactic surfactant.
abstract: OBJECTIVE
  To compare the effectiveness of a prophylactic surfactant treatment strategy (PRO) to the effectiveness of a rescue (RESC) surfactant treatment strategy in patients at high risk for developing hyaline membrane disease (HMD).
  
  
  METHODS
  We analyzed data from a retrospective cohort consisting of all patients admitted to the neonatal intensive care units at the centers participating in the recently completed Infasurf-Survanta Comparative Trial. To be in the cohort, a patient had to be admitted during the trial, be <48 hours of age on admission, have a gestational age of <30 weeks, have a birth weight of 501 to 1250 gm, and be free of congenital anomalies. Twelve centers participated in this study. They contributed 1097 patients of whom 381 were treated with a PRO strategy.
  
  
  RESULTS
  Survival was significantly higher in the PRO-strategy patients (84% vs 72%, p < 0.05) as was survival without oxygen requirement at a postconceptional age of 36 weeks (60% vs 46%, p < 0.05). In addition, the patients with PRO had a lower prevalence of grade III and IV intraventricular hemorrhage (IVH, 9% vs 14%, p < 0.05). All analyses were controlled for birth weight and type of study center.
  
  
  CONCLUSIONS
  These data support the conclusion that using a PRO treatment strategy results in improved survival in patients at risk for developing HMD. A PRO treatment strategy may also decrease the likelihood of developing a severe IVH.
authors.affiliation: Newark Beth Israel Medical Center, Department of Pediatrics, NJ 07112, USA.
authors.forename: D R
authors.initials: DR
authors.lastname: Brown
authors.forename: B T
authors.initials: BT
authors.lastname: Bloom
authors.forename: M
authors.initials: M
authors.lastname: Cohen
authors.forename: M M
authors.initials: MM
authors.lastname: Myers
authors.forename: E A
authors.initials: EA
authors.lastname: Egan
authors.forename: J
authors.initials: J
authors.lastname: Kattwinkel
authors.forename: P
authors.initials: P
authors.lastname: Delmore
authors.forename: R T
authors.initials: RT
authors.lastname: Hall
authors.forename: M H
authors.initials: MH
authors.lastname: Malloy
authors.forename: I R
authors.initials: IR
authors.lastname: Holzman
authors.forename: W A
authors.initials: WA
authors.lastname: Carlo
authors.forename: A K
authors.initials: AK
authors.lastname: Pramanik
authors.forename: M A
authors.initials: MA
authors.lastname: McCaffree
authors.forename: K B
authors.initials: KB
authors.lastname: Weatherstone
authors.forename: L D
authors.initials: LD
authors.lastname: Willett
authors.forename: W H
authors.initials: WH
authors.lastname: Topper
mesh_terms: D002543:Cerebral Hemorrhage / Q000150:complications; D006801:Humans; D006819:Hyaline Membrane Disease / Q000517:prevention & control*; D007226:Infant Mortality; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D011663:Pulmonary Surfactants / Q000627:therapeutic use*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D011663:Pulmonary Surfactants