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Comparative trial of artificial and natural surfactants in the treatment of respiratory distress syndrome of prematurity: Experiences in a developing country
Author(s) -
da Costa David E.,
Pai M.G.K.,
Al Khusaiby Saleh M.
Publication year - 1999
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/(sici)1099-0496(199905)27:5<312::aid-ppul3>3.0.co;2-n
Subject(s) - medicine , respiratory distress , anesthesia , incidence (geometry) , respiratory disease , oxygenation index , randomized controlled trial , lung disease , lung , oxygenation , physics , optics
We conducted a randomized clinical trial to compare the effects of a synthetic (Exosurf®) and natural (Survanta®) surfactant in infants with neonatal respiratory distress syndrome. Eighty‐nine patients were randomly allocated to receive one of the two surfactants. Primary outcome variables were the acute and long‐term effects of the surfactant preparations, i.e., ventilatory requirements at 24 h of age as judged by the oxygenation index (OI), and the combined incidence of chronic lung disease or death at 28 days. The OIs in the Exosurf® and Survanta® groups at 24 h were the same (10.1 and 7, respectively; P > 0.05). The magnitude and rapidity of response, however, were greater for Survanta® than for Exosurf®. When arterial/alveolar oxygen tension ratios (a/A) were compared, the Exosurf® group had a significantly worse a/A ratio at 24 h than the Survanta® group (0.21 Exosurf® vs. 0.37 Survanta®; P < 0.05). The long‐term outcome as judged by the combined incidence of death or chronic lung disease was not different in the two groups (18.6% Exosurf® vs. 15.2% Survanta®; P > 0.05). When the complications of prematurity were compared, there were no statistically significant differences between the two groups. We conclude that both preparations are reasonable choices for the treatment of respiratory distress syndrome of prematurity. Pediatr Pulmonol. 1999;27:312–317. © 1999 Wiley‐Liss, Inc.