title: [Prophylaxis and treatment of respiratory distress syndrome with different surfactants].
abstract: BACKGROUND
  Etiological treatment of respiratory distress syndrome due to lung immaturity with exogenous surfactant is of proven efficacy. However, it is not clear whether all the exogenous surfactants available, both natural and synthetic, are of equal efficacy.
  
  
  OBJECTIVE
  To evaluate whether there is any evidence to support the efficacy of one exogenous surfactant over that of the others in the prophylaxis and treatment of respiratory distress syndrome.
  
  
  METHODS
  To identify all the comparative studies of tensoactive compounds, an intensive bibliographic search was performed in several databases.
  
  
  RESULTS
  Data was found to corroborate that natural surfactants improve oxygenation more rapidly than synthetic surfactants. Natural surfactants also have lower complication and mortality rates. Of the two natural surfactants available in Spain, the porcine-derived surfactant (poractant-alfa) seems to present some advantages over the bovine-derived surfactant (beractant), such as faster action, expressed as a more favourable PaO2/PAO2 ratio during the first 24 hours of treatment. There is also a trend indicating that newborns treated with porcine surfactant have a lower overall mortality rate (3 %) compared with those treated with bovine surfactant (12.5 %).
  
  
  CONCLUSIONS
  No scientific evidence supports the current use of commercialised synthetic surfactants. The porcine-derived surfactant can be considered as the preparation of choice, although additional studies confirming this finding would be useful.
authors.affiliation: Servicio de Pediatría, Hospital de La Moncloa, Madrid, Spain.
authors.forename: V M
authors.initials: VM
authors.lastname: Navas Serrano
authors.forename: M A
authors.initials: MA
authors.lastname: Cuevas García
authors.forename: J A
authors.initials: JA
authors.lastname: Vila Alvarez
authors.forename: V
authors.initials: V
authors.lastname: Martínez Fernández
authors.forename: F
authors.initials: F
authors.lastname: Morcillo Sopena
authors.forename: A
authors.initials: A
authors.lastname: Valls I Soler
mesh_terms: D006801:Humans; D007231:Infant, Newborn; D011663:Pulmonary Surfactants / Q000627:therapeutic use*; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy* / Q000517:prevention & control*
chemical_list: D011663:Pulmonary Surfactants