Surfactant therapy in preterm infants with respiratory distress syndrome and in near-term or term newborns with acute RDS.
Many different surfactant preparations derived from animal sources, as well as synthetic surfactants, are available for the treatment of preterm infants with respiratory distress syndrome (RDS). Natural, modified surfactants containing surfactant-associated proteins appear to be more effective than non-protein-containing synthetic surfactants. Comparative trials with poractant alfa at a higher initial dose of 200 mg/kg appear to be associated with rapid weaning of FiO2, less need for additional doses, and decreased mortality in infants <32 weeks gestation when compared with beractant. Early rescue (<30 min of age) surfactant therapy is an effective method to minimize over treatment of some preterm infants who may not develop RDS. Surfactant therapy followed by rapid extubation to nasal ventilation appears to be more beneficial than continued mechanical ventilation. In near-term or term newborns with acute RDS, surfactant therapy has been shown to be 70% effective in improving respiratory failure.
Ramanathan
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R
Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA. ramanath@usc.edu
D001688:Biological Products / Q000627:therapeutic use; D045422:Continuous Positive Airway Pressure; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D010743:Phospholipids / Q000627:therapeutic use; D011663:Pulmonary Surfactants / Q000008:administration & dosage / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy* / Q000628:therapy; D013501:Surface-Active Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
D001688:Biological Products; D010743:Phospholipids; D011663:Pulmonary Surfactants; D013501:Surface-Active Agents; C068291:poractant alfa; C072197:beractant