Comparison of animal-derived surfactants for the prevention and treatment of respiratory distress syndrome in preterm infants

Singh, Neetu; Halliday, Henry L.; Stevens, Timothy P.; Soll, Roger F.

doi:10.1002/14651858.cd010249

Cited by 31 publications

(63 citation statements)

References 16 publications

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“…Hence, to corroborate the histological results obtained, there is a need for studies that investigate longer-term outcomes and specifically that measure brain injury markers (eg, ionized calcium binding adapter molecule 1; glial fibrillary acid protein; and myelin basic protein) 34,35 to ascertain which types of cells may be injured. 36,37 and our study confirms these findings.…”

Section: Discussionsupporting

confidence: 90%

“…SF therapy is one of the few treatments that decreases overall mortality in preterm newborns with RDS and has significantly changed clinical practice in neonatology, in ways that may strongly influence the infants’ neurodevelopmental prognosis. Several clinical trials have previously reported the pulmonary benefits of Curosurf administration, without an increased risk of brain injury compared with other natural SF treatments, and our study confirms these findings.…”

Section: Discussionsupporting

confidence: 90%

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Cerebral and lung effects of a new generation synthetic surfactant with SP‐B and SP‐C analogs in preterm lambs

Rey-Santano

Mielgo

Murgia

et al. 2017

Pediatric Pulmonology

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 90%

Cerebral and lung effects of a new generation synthetic surfactant with SP‐B and SP‐C analogs in preterm lambs

Rey-Santano

Mielgo

Murgia

et al. 2017

Pediatric Pulmonology

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“…Poractant alfa (porcine) and beractant (bovine) are natural animal‐derived surfactants commonly used in the treatment of RDS in preterm infants. A 2015 Cochrane analysis classified natural surfactants as bovine‐ and porcine‐derived according to their source and emphasized that porcine surfactants resulted in better clinical outcomes . An extensive meta‐analysis evaluating the relationship between surfactant treatment and mortality showed a trend toward lower mortality with poractant administered at an initial dose of 200 mg/kg compared with 100 mg/kg poractant or 100 mg/kg beractant .…”

Section: Introductionmentioning

confidence: 99%

Effect of two different early rescue surfactant treatments on mortality in preterm infants with respiratory distress syndrome

Şimşek

Kutman

Canpolat

et al. 2019

Clinical Respiratory J

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Introduction Although current evidence suggests that initial dose of 200 mg/kg poractant alfa reduces mortality in the treatment of respiratory distress syndrome (RDS), these data were obtained in a highly heterogeneous group of patients and neither of them addressed mortality as primary outcome. Objective The aim of this study was to investigate the effects of poractant alfa and beractant on mortality when administered as early rescue surfactant therapy in very preterm infants. Methods We retrospectively evaluated preterm infants followed in our unit between May 2017 and November 2018 whose gestational age (GA) was ≤28 weeks and received surfactant within the first 2 hours of life. Morbidities and mortality rates were compared between infants who received initial doses of 200 mg/kg poractant alfa and 100 mg/kg beractant. Results Data from 200 infants who met the inclusion criteria were analyzed. There were 112 patients in the poractant alfa group and 88 patients in beractant group. Mean gestational age in these groups was 26 ± 2 and 25.8 ± 1.8 weeks (P = 0.45) and mean birth weight was 812 ± 243 and 840 ± 208 g (P = 0.39), respectively. The poractant alfa and beractant groups had similar rates of overall mortality (53.5% vs 56.8%), mortality in first 7 days (30.5% vs 25.8%), and beyond day 7 (16.4% vs 13.3%) (P > 0.05). There were no differences in the incidence of preterm morbidities among the two groups. Conclusion We were unable to demonstrate the superiority of poractant in terms of mortality in very preterm infants with RDS. These findings need to be supported by multicenter, randomized controlled trials.

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“…Animal‐derived surfactants differ in their phospholipids, surfactant proteins B and C, and plasmalogens composition, as well as their viscosity and volume adminstration . While numerous randomized controlled trials have compared different animal‐derived preparations, it remains unclear whether significant differences in clinical outcomes exist among them …”

Section: Introductionmentioning

confidence: 99%

“…Bovine lipid extract surfactant (BLES Biochemicals, London, Canada) is commonly used to treat RDS in premature infants in neonatal intensive care units (NICUs) across Canada, India, South Africa, Iran, Saudi Arabia, Bolivia, and Chile. It is a natural extract of bovine pulmonary surfactant, containing 1% SP‐B and SP‐C and a phospholipid concentration of 27 mg/mL. Despite the popular use of BLES, there are limited published trials for its use in the treatment of RDS in preterm infants .…”

Section: Introductionmentioning

confidence: 99%

Effects of bovine lipid extract surfactant administration in preterm infants treated for respiratory distress syndrome

Stockley

Valotaire

Miller

et al. 2018

Health Science Reports

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AimTo review the initial effectiveness of bovine lipid extract surfactant (BLES) for the treatment of respiratory distress syndrome in preterm infants.Methods and resultsA retrospective review of data collected from infants born <37‐week gestation with respiratory distress syndrome treated with BLES between February 1, 2015 and March 1, 2016. Data were analyzed to determine the timing of initial dose, the length of time to wean the fraction of inspired oxygen (FiO2) concentration to 0.21 following initial dose, and the number of repeated doses given during hospital admission. Infants were subgrouped by gestational age stratum, 230 to 276 weeks (group 1), 280 to 316 weeks (group 2), and 320 to 366 weeks (group 3). Ninety‐eight infants received the surfactant during the study period. After applying exclusion criteria, 77 infants were analyzed. Mean (SD) gestational age was 28 (4) weeks, and mean (SD) birth weight was 1250 (602) g. Initial dose of BLES was given at a median (interquartile range) time of 29 (19‐43) minutes in group 1, 150 (20‐615) minutes in group 2, and 990 (53‐2025) minutes in group 3. Median (interquartile range) length of time to wean the FiO2 concentration to 0.21 was 14 (5‐56) minutes, 10 (5‐53) minutes, and 10 (5‐38) minutes in groups 1, 2, and 3, respectively. Ten infants required repeated doses.ConclusionGiven the rapid response of BLES in all the groups, careful monitoring of ventilator parameters is paramount to allow for rapid weaning and early extubation to avoid lung injury associated with mechanical ventilation.

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Comparison of animal-derived surfactants for the prevention and treatment of respiratory distress syndrome in preterm infants

Cited by 31 publications

References 16 publications

Cerebral and lung effects of a new generation synthetic surfactant with SP‐B and SP‐C analogs in preterm lambs

Cerebral and lung effects of a new generation synthetic surfactant with SP‐B and SP‐C analogs in preterm lambs

Effect of two different early rescue surfactant treatments on mortality in preterm infants with respiratory distress syndrome

Effects of bovine lipid extract surfactant administration in preterm infants treated for respiratory distress syndrome

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