Objective: Comparison of the differences between availability of animalderived surfactant preparations used to treat premature infants is incomplete. The objective of this study was to assess the short-term treatment efficacy of the two most commonly used surfactant preparations in the United States, beractant (100 mg kg Result: We studied 52 infants 24 0/7 to 29 6/7 weeks gestation; 25 received poractant alfa (27.1±1.6 weeks, birth weight of 930±231 g) and 27 received beractant (26.7 ± 1.7 weeks, P ¼ 0.343 and birth weight 900 ± 271 g, P ¼ 0.668). Respiratory support for the first 72 h of life was lower in the poractant alfa than beractant group for mean airway pressure (MAP, P ¼ 0.003) and respiratory index (MAP Â FiO 2 , P ¼ 0.032). Infants in the poractant alfa group had a greater number of infants extubated at 48 (13/25 vs 6/27, P ¼ 0.027) and 72 h (15/25 vs 8/27, P ¼ 0.029) than the beractant group. Although the study was not powered to detect morbidities of prematurity, the prevalence of PDA and air leaks was less in the infants treated with poractant alfa than in those treated with beractant. Rates of bronchopulmonary dysplasia (8/23 vs 11/ 22, P ¼ 0.303) or death (2/15 vs 5/27, P ¼ 0.272) were similar in the infants treated with poractant alfa and beractant, respectively.
Conclusion:This study suggests significant short-term benefits to the use of the larger initial dose of poractant alfa than beractant in very premature infants with RDS. Further studies involving a larger number of preterm infants are needed to assess long-term effects.