Prophylactic administration of porcine-derived lung surfactant is a significant factor in reducing the odds for peri-intraventricular haemorrhage in premature infants.
We hypothesized that prophylactic treatment with a porcine-modified lung surfactant (PLS) reduces the rate of peri-intraventricular haemorrhage (PIVH) more than rescue treatment. We performed a meta-analysis of three prophylactic versus rescue trials conducted with PLS in four countries using individual data. Overall (grades 1-4) or severe (grades 3 and 4) PIVH of 671 newborns was the outcome. A logistic regression analysis was performed. Prophylactic exposure to PLS was a significant independent factor in reducing the incidence of overall (OR 0.65; 95% CI 0.47-0.90) and severe (OR 0.56; 95% CI 0.35-0.89) PIVH. Moreover, for severe PIVH, the adjusted OR for outborn babies exposed to prophylactic treatment with PLS was highly significant (OR 0.11; 95% CI 0.02-to 0.49). The results we obtained show that prophylactic treatment with PLS reduces the rate of PIVH more than rescue treatment.
Walti
Hervé
H
Service de Médecine Néonatale, CHU Cochin-Port-Royal, INSERM U-149, Paris, France. herve.walti@courrier.usherb.ca
Paris-Llado
Josefa
J
Egberts
Johannes
J
Brand
Roland
R
Bevilacqua
Giulio
G
Gardini
Fabrizio
F
Bréart
Gérard
G
D000818:Animals; D002543:Cerebral Hemorrhage / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D002552:Cerebral Ventricles / Q000187:drug effects*; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D015337:Multicenter Studies as Topic; D011663:Pulmonary Surfactants / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D013552:Swine
D011663:Pulmonary Surfactants