[Treatment of hyaline membrane disease in the preterm newborn with exogenous lung surfactant: a controlled study].
BACKGROUND
Hyaline membrane disease (HMD) due to lung surfactant deficiency in the preterm newborn is an important cause of neonatal morbidity and mortality. Exogenous lung surfactant has transformed HMD therapy in developed countries, but an equivalent benefit has not been accomplished in developing countries due to a variety of factors. Porcine surfactant developed in Cuba is an inexpensive alternative to other surfactants, and its use has not been studied in our settings.


METHODS
A randomized, open, prospective and controlled trial was undertaken in 44 preterm newborns with HMD diagnosis. One group received bovine surfactant (BS) (Survanta) and the other Cuban porcine surfactant (PS) (Surfacen). The following clinical response variables were evaluated: oxygenation and ventilation indexes, days with supplementary oxygen, days with mechanical ventilation, incidence of complications, time of hospitalization, and mortality.


RESULTS
23 Patients received bovine surfactant and 21 the porcine type. The two groups were clinically similar, with patterns of oxygenation and ventilation response that were the same between groups, with a tendency to higher initial oxygenation increase in the PS group. The incidence of complications was similar between groups. 10 Patients (47.6%) died in the PS group, versus 12 (52.2%) in the BS group (p > 0.05).


CONCLUSIONS
Porcine surfactant had similar clinical effects than bovine surfactant in the oxygenation and ventilation variables, with no significant differences in complications ormortality. Porcine surfactant is an effective and lower cost altenative to bovine surfactant in the treatment of HMD.
Sánchez-Mendiola
Melchor
M
Departamento de Medicina Crítica Pediátrica, Hospital Central Militar, DF, Mexico. Melchor_sanchez@terra.com.mx
Martínez-Natera
Octavio C
OC
Herrera-Maldonado
Nazarea
N
Ortega-Arroyo
Jesús
J
D001034:Apgar Score; D001688:Biological Products / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006819:Hyaline Membrane Disease / Q000097:blood / Q000150:complications / Q000401:mortality / Q000628:therapy*; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D010100:Oxygen / Q000097:blood; D010102:Oxygen Inhalation Therapy; D010743:Phospholipids / Q000627:therapeutic use; D011446:Prospective Studies; D011663:Pulmonary Surfactants / Q000191:economics / Q000627:therapeutic use*; D012121:Respiration, Artificial; D013997:Time Factors
D001688:Biological Products; D010743:Phospholipids; D011663:Pulmonary Surfactants; C068291:poractant alfa; C072197:beractant; D010100:Oxygen