Document Detail


Animal-derived surfactants: where are we? The evidence from randomized, controlled clinical trials.
MedLine Citation:
PMID:  19399008     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Animal-derived surfactants, as well as synthetic surfactants, have been extensively evaluated in the treatment of respiratory distress syndrome (RDS) in preterm infants. Three commonly available animal-derived surfactants in the United States include beractant (BE), calfactant (CA) and poractant alfa (PA). Multiple comparative studies have been performed using these three surfactants. Prospective as well as retrospective studies comparing BE and CA have shown no significant differences in clinical or economic outcomes. Randomized, controlled clinical trials have shown that treatment with PA is associated with rapid weaning of oxygen and ventilatory pressures, fewer additional doses, cost benefits and survival advantage when compared with BE or CA. Recently, a study using an administrative database that included over 20,000 preterm infants has shown a significant decrease in mortality and cost benefits in favor of PA, when compared with BE or CA. Differences in outcomes between these animal-derived surfactants may be related to a higher amount of phospholipids and plasmalogens in PA. To date, animal-derived surfactants seem to be better than synthetic surfactants during the acute phase of RDS and in decreasing neonatal mortality. Further studies are needed comparing animal-derived surfactants with the newer generation of synthetic surfactants.
Authors:
R Ramanathan
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Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  29 Suppl 2     ISSN:  1476-5543     ISO Abbreviation:  J Perinatol     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-28     Completed Date:  2009-08-04     Revised Date:  2013-06-03    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S38-43     Citation Subset:  IM    
Affiliation:
Division of Neonatal Medicine, Department of Pediatrics, Women's and Children's Hospital and Childrens Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA. ramanath@usc.edu
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MeSH Terms
Descriptor/Qualifier:
Animals
Biological Agents / administration & dosage,  adverse effects,  chemical synthesis
Evidence-Based Medicine*
Humans
Infant, Newborn
Intensive Care, Neonatal
Phospholipids / administration & dosage,  adverse effects,  chemical synthesis
Pulmonary Surfactants / administration & dosage,  adverse effects,  chemical synthesis*
Randomized Controlled Trials as Topic*
Respiratory Distress Syndrome, Newborn / drug therapy*,  mortality
Survival Rate
Treatment Outcome
Ventilator Weaning
Chemical
Reg. No./Substance:
0/Biological Agents; 0/Phospholipids; 0/Pulmonary Surfactants; 0/calfactant; 108778-82-1/beractant; KE3U2023NP/poractant alfa

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