title: Randomized trial comparing two natural surfactants (Survanta vs. bLES) for treatment of neonatal respiratory distress syndrome.
abstract: Exogenous surfactants have been used as an effective treatment of neonatal respiratory distress syndrome (RDS). Different preparations of surfactant carry different biophysical and clinical properties. To study the response pattern and treatment outcome of two natural surfactants (bLES and Survanta) for the treatment of RDS, we conducted a randomized clinical trial at the neonatal unit of a university teaching hospital. Premature babies with birth weight between 500-1,800 g who developed RDS requiring mechanical ventilation with an oxygen requirement of more than 30% within 6 hr of life were randomized into two treatment groups. Oxygenation indices (OIs) within 12 hr of treatment were compared as primary outcomes, while neonatal complications were analyzed as secondary outcomes of the study. Sixty babies were recruited, with 29 in the bLES and 31 in the Survanta treatment group. Both groups had significant and sustained improvements in OI after surfactant replacement therapy (SRT), while the bLES group was associated with a significantly lower OI throughout the initial 12 hr after treatment compared with the Survanta group. There was no difference in secondary outcomes including mortality, ventilator days, and occurrence of chronic lung disease. We conclude that infants with RDS respond favorably to both types of surfactant replacement, and that bLES achieved a faster clinical response in terms of improvement in OI than Survanta.
authors.affiliation: Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, China. lamccb@ha.org.hk
authors.forename: Barbara C C
authors.initials: BC
authors.lastname: Lam
authors.forename: Yiu Ki
authors.initials: YK
authors.lastname: Ng
authors.forename: Kar Yin
authors.initials: KY
authors.lastname: Wong
mesh_terms: D001688:Biological Products / Q000627:therapeutic use*; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D008171:Lung Diseases / Q000209:etiology / Q000517:prevention & control; D008297:Male; D010100:Oxygen / Q000097:blood; D011663:Pulmonary Surfactants / Q000627:therapeutic use*; D012121:Respiration, Artificial; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D001688:Biological Products; D011663:Pulmonary Surfactants; C072197:beractant; D010100:Oxygen