title: Pilot trial of late booster doses of surfactant for ventilated premature infants.
abstract: OBJECTIVE
  Many premature infants at risk for bronchopulmonary dysplasia experience episodes of surfactant dysfunction with reduced surfactant protein B (SP-B). In this study, we investigated the safety and responses to booster doses of surfactant.
  
  
  METHODS
  A total of 87 infants, 500 to 1250 g birth weight, who were ventilated at 7 to 10 days received 2 or 3 doses of Infasurf (Calfactant, Forest Pharmaceuticals, St Louis, MO, USA) within a 1-week period.
  
  
  RESULTS
  For 184 doses, occurrence rates of transient bradycardia (13) and plugged endotracheal tube (5) were low, and no other adverse effects were noted. Treatment transiently improved the respiratory severity score (FiO(2) × mean airway pressure), SP-B content (+75%) and surface properties of isolated surfactant. Levels of eight proinflammatory cytokines in tracheal aspirate were interrelated and unchanged from baseline after surfactant treatment.
  
  
  CONCLUSIONS
  Booster doses of surfactant for premature infants with lung disease are safe and transiently improve respiratory status as well as composition and function of endogenous surfactant.
authors.affiliation: Department of Pediatrics, Division of Neonatology, Children's Hospital and Research Center Oakland, Oakland, CA 94609, USA. jmerrill@mail.cho.org
authors.forename: J D
authors.initials: JD
authors.lastname: Merrill
authors.forename: P L
authors.initials: PL
authors.lastname: Ballard
authors.forename: S E
authors.initials: SE
authors.lastname: Courtney
authors.forename: D J
authors.initials: DJ
authors.lastname: Durand
authors.forename: A
authors.initials: A
authors.lastname: Hamvas
authors.forename: A M
authors.initials: AM
authors.lastname: Hibbs
authors.forename: K W
authors.initials: KW
authors.lastname: Lu
authors.forename: R M
authors.initials: RM
authors.lastname: Ryan
authors.forename: A M
authors.initials: AM
authors.lastname: Reynolds
authors.forename: K
authors.initials: K
authors.lastname: Spence
authors.forename: R H
authors.initials: RH
authors.lastname: Steinhorn
authors.forename: W E
authors.initials: WE
authors.lastname: Truog
authors.forename: E C
authors.initials: EC
authors.lastname: Eichenwald
authors.forename: R A
authors.initials: RA
authors.lastname: Ballard
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D010865:Pilot Projects; D011663:Pulmonary Surfactants / Q000008:administration & dosage*; D012121:Respiration, Artificial; D016896:Treatment Outcome
chemical_list: D011663:Pulmonary Surfactants