Randomized clinical trial comparing two natural surfactant preparations to treat respiratory distress syndrome.
OBJECTIVE
Natural surfactant preparations have been shown to reduce the severity and mortality of respiratory distress syndrome (RDS) in preterm infants. The objective of this study was to compare the efficacy of two natural surfactants, namely SF-RI 1 (Alveofact) and barectant (Survanta), on the incidence of chronic lung disease (CLD) and other associated complications of RDS in preterm infants.


METHODS
Preterm infants with RDS requiring artificial ventilation were randomly selected to receive an initial dose of either Alveofact or Survanta. The two treatment groups were tested for variation in gas exchange, ventilatory settings and neonatal complications such as CLD and mortality.


RESULTS
After 5 days the Survanta-treated infants had a lower fraction of inspired oxygen (FiO2) compared with the Alveofact-treated infants. There were no differences in the ventilatory settings. More infants in the Survanta group were extubated at 3 days and fewer required the use of postnatal steroids. Less CLD and duration of oxygenation were experienced by the Survanta-treated group.


CONCLUSIONS
Improved oxygenation and reduced ventilatory requirements were greater with Survanta compared to Alveofact, which in turn was associated with a trend towards a lower incidence of serious pulmonary complications.
Department of Pediatrics, Faculty of Medicine, Kuwait University, Safat, Kuwait.
M
M
Hammoud
N
N
Al-Kazmi
M
M
Alshemmiri
L
L
Thalib
V T
VT
Ranjani
L V
LV
Devarajan
H
H
Elsori
D001688:Biological Products / Q000008:administration & dosage / Q000627:therapeutic use*; D003422:Critical Care; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008055:Lipids / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D010743:Phospholipids / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D012121:Respiration, Artificial; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy*; D013501:Surface-Active Agents / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome
D001688:Biological Products; D008055:Lipids; D010743:Phospholipids; C078272:SF-RI 1, bovine surfactant preparation; D013501:Surface-Active Agents; C072197:beractant