Document Detail


Mortality, severe respiratory distress syndrome, and chronic lung disease of the newborn are reduced more after prophylactic than after therapeutic administration of the surfactant Curosurf.
MedLine Citation:
PMID:  9200378     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To test the hypothesis that prophylactic treatment with the surfactant Curosurf (Chiesi Farmaceutici SPA, Parma, Italy) improves survival and respiratory problems more than rescue treatment.
DESIGN: Meta-analysis of three prophylaxis versus rescue treatment trials, conducted in four countries.
METHODS: A meta-analysis was performed with the original, individual data of mortality, severe respiratory distress syndrome, and chronic lung disease of 671 newborns as outcomes. The random-effects logistic model (accounting for the trial-within-country structure) was applied and adjusted for imbalances in covariates.
RESULTS: The probability of each outcome differed between the countries, but the actual treatment effect itself did not. The adjusted odds ratios (ORs) and confidence intervals (CIs) for prophylaxis versus rescue were as follows: mortality: OR, .47; 95% CI, .30 to .73; severe RDS: OR, .50; 95% CI, .33 to .74; and chronic lung disease of the newborn in the survivors at day 28 after birth: OR, .54; 95% CI, .34 to .86. Gender, birth weight, gestational age, and prenatal administration of glucocorticosteroids were significant confounding covariates.
CONCLUSION: The analysis shows that for the porcine surfactant Curosurf, prophylactic administration of surfactant has significant advantages over rescue therapy.
Authors:
J Egberts; R Brand; H Walti; G Bevilacqua; G Bréart; F Gardini
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Publication Detail:
Type:  Journal Article; Meta-Analysis    
Journal Detail:
Title:  Pediatrics     Volume:  100     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  1997 Jul 
Date Detail:
Created Date:  1998-09-11     Completed Date:  1998-09-11     Revised Date:  2013-06-03    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  E4     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, University of Leiden, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Biological Agents*
Chronic Disease
Clinical Trials as Topic
Confounding Factors (Epidemiology)
Drug Administration Schedule
Female
Humans
Infant, Newborn
Logistic Models
Lung Diseases / mortality,  prevention & control
Male
Odds Ratio
Phospholipids*
Pulmonary Surfactants / administration & dosage*
Random Allocation
Respiratory Distress Syndrome, Newborn / mortality*,  prevention & control*
Sex Characteristics
Survival Rate
Treatment Outcome
Chemical
Reg. No./Substance:
0/Biological Agents; 0/Phospholipids; 0/Pulmonary Surfactants; KE3U2023NP/poractant alfa

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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