Pumactant and poractant alfa for treatment of respiratory distress syndrome in neonates born at 25–29 weeks' gestation: a randomised trial

@article{Ainsworth2000PumactantAP,
  title={Pumactant and poractant alfa for treatment of respiratory distress syndrome in neonates born at 25–29 weeks' gestation: a randomised trial},
  author={Sb Ainsworth and M W Beresford and D. W. A. Milligan and Nj Shaw and Jns Matthews and AC Fenton and M. W. Platt},
  journal={The Lancet},
  year={2000},
  volume={355},
  pages={1387-1392}
}
View on Elsevier
doi.org
104 Citations
Highly Influential Citations
7
Background Citations
25
Results Citations
7

104 Citations

Complications among premature neonates treated with beractant and poractant alfa

In this study, infants who received poractant had shorter duration of intubation than infants treated with beractant, without any difference in the duration of oxygen therapy or hospitalization.

Is there a Difference in Surfactant Treatment of Respiratory Distress Syndrome in Premature Neonates? A Review

New surfactant administration strategies are described, complimenting new respiratory support strategies, designed to minimize invasive mechanical ventilation and decrease the frequency of chronic lung disease.

An observational study of surfactant treatment in infants of 23–30 weeks' gestation: comparison of prophylaxis and early rescue

  • G. BevilacquaS. Parmigiani
  • Medicine
    The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
  • 2003
Not surprisingly, infants treated with prophylactic surfactant had a lower rate of RDS than the infants treated by early rescue, even though they did not need less Surfactant overall.

History of Surfactant from 1980

Comparison studies show that multiple doses may be needed if surfactant is used to treat established RDS but early or prophylactic treatment is superior for infants with gestational ages less than 30 weeks, and a meta-analysis of 5 comparative studies suggests that a dose of 200 mg/kg of poractant alfa is associated with lower mortality compared with 100 mg/ kg of beractant.

Poractant alfa versus bovine lipid extract surfactant for infants 24+0 to 31+6 weeks gestational age: A randomized controlled trial

Poractant alfa may be more beneficial and associated with fewer complications than bovine lipid extract surfactant and larger studies are needed to determine whether observed possible benefits translate in shorter hospital admissions, or other long term benefits and determine whether there is a difference in mortality.

Surfactant Therapy for Respiratory Distress Syndrome in Premature Neonates

  • S. AinsworthD. Milligan
  • Medicine
    American journal of respiratory medicine : drugs, devices, and other interventions
  • 2002
Despite being an effective therapy for RDS, surfactant has failed to have a significant impact on the incidence of chronic lung disease in survivors and is considered a cost-effective therapy compared with other therapeutic interventions in premature infants.

Choosing a Right Surfactant for Respiratory Distress Syndrome Treatment

Evidence from randomized controlled trials indicates that treatment with natural surfactant results in faster weaning of supplemental oxygen and mean airway pressure, decreased duration of mechanical ventilation, and decreased mortality when compared to synthetic surfactants.

Does surfactant type cause a differential proinflammatory response in preterm infants with respiratory distress syndrome?

The postnatal airway inflammatory response observed in preterm infants is not altered by the instillation of either surfactant preparation, and ventilation requirements and clinical outcomes were similar between the two groups.

Surfactant for respiratory distress syndrome: are there important clinical differences among preparations?

The emergence of a newer generation of synthetic, peptide-containing surfactants has opened a new era in surfactant therapy which may have implications for future practice and research.

Non-invasive surfactant administration in newborn babies

The present trend in neonatal medicine is to reduce invasiveness; with the aim of lessening unnecessary procedures which themselves may result in a worsened outcome and it is clear that some preterm…
...

References

SHOWING 1-10 OF 26 REFERENCES

A multicenter randomized masked comparison trial of synthetic surfactant versus calf lung surfactant extract in the prevention of neonatal respiratory distress syndrome.

Treatment with Infasurf resulted in significant improvement in several secondary outcome measures and is suggested that a more effective surfactant is a better option than Exosurf in the prevention of neonatal respiratory distress syndrome.

Randomised clinical trial of two treatment regimens of natural surfactant preparations in neonatal respiratory distress syndrome.

The Curosurf treatment regimen resulted in a more rapid improvement in oxygenation than Survanta and reduced ventilatory requirements up to 24 hours after start of treatment, associated with a trend towards reduced incidence of serious pulmonary and non-pulmonary complications.

A multicenter, randomized trial comparing synthetic surfactant with modified bovine surfactant extract in the treatment of neonatal respiratory distress syndrome

Although no differences were noted between Survanta- and Exosurf-treated infants regarding the primary outcome of death or chronic lung disease at 28 days of age, the significant improvement in secondary clinical outcomes suggests that SurvantA is more effective than ExosURf Neonatal in the treatment of established RDS.

TWO CONTROLLED TRIALS OF DRY ARTIFICIAL SURFACTANT: EARLY EFFECTS AND LATER OUTCOME IN BABIES WITH SURFACTANT DEFICIENCY

A multicenter randomized trial comparing two surfactants for the treatment of neonatal respiratory distress syndrome. National Institute of Child Health and Human Development Neonatal Research Network.

Randomized trial of artificial surfactant (ALEC) given at birth to babies from 23 to 34 weeks gestation.

Manual Ventilation with a Few Large Breaths at Birth Compromises the Therapeutic Effect of Subsequent Surfactant Replacement in Immature Lambs

It is concluded that a few inflations with volumes that are probably harmless in other circumstances might, when forced into the surfactant-deficient lung immediately at birth, compromise the effect of subsequent Surfactant rescue treatment.

Artificial surfactant and natural surfactant. Comparative study of the effects on premature rabbit lungs.

These findings confirm earlier observations that treatment with supplementary surfactant has a beneficial effect on lung mechanics in the premature neonate and the fact that this effect can be obtained not only with natural Surfactant but also with dry artificial surfactants should increase the possibility of clinical application.

Beneficial effects of the combined use of prenatal corticosteroids and postnatal surfactant on preterm infants.

Comparison of mortality risk: a score for very low birthweight infants

The present score is robust, easily obtainable at admission, and permits early randomisation based on mortality risk, which quantifies mortality risk in very low birthweight infants at admission to the neonatal intensive care unit.