Document Detail


Poractant alfa and beractant treatment of very premature infants with respiratory distress syndrome.
MedLine Citation:
PMID:  20336076     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Comparison of the differences between availability of animal-derived 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(-1) initial and subsequent doses) and poractant alfa (200 mg kg(-1) initial and 100 mg kg(-1) subsequent doses), in very premature, mechanically ventilated infants <30 weeks gestation with respiratory distress syndrome (RDS).
STUDY DESIGN: Inborn infants at two institutions, open label, 1:1, randomized controlled trial. Level of respiratory support for first 72 h of life. Morbidities of prematurity observed during the neonatal intensive care unit hospitalization.
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=0.343 and birth weight 900±271 g, P=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=0.003) and respiratory index (MAP × FiO(2), P=0.032). Infants in the poractant alfa group had a greater number of infants extubated at 48 (13/25 vs 6/27, P=0.027) and 72 h (15/25 vs 8/27, P=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=0.303) or death (2/25 [corrected] vs 5/27, P=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.
Authors:
A M Fujii; S M Patel; R Allen; G Doros; C-Y Guo; S Testa
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-03-25
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  30     ISSN:  1476-5543     ISO Abbreviation:  J Perinatol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-29     Completed Date:  2011-01-20     Revised Date:  2013-06-03    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  665-70     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Boston University School of Medicine, Boston, MA 02118, USA. Alan.Fujii@bmc.org
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MeSH Terms
Descriptor/Qualifier:
Biological Agents / administration & dosage,  therapeutic use*
Clinical Protocols
Female
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / drug therapy*
Male
Phospholipids / administration & dosage,  therapeutic use*
Prospective Studies
Pulmonary Surfactants / administration & dosage,  therapeutic use*
Respiration, Artificial
Respiratory Distress Syndrome, Newborn / drug therapy*,  physiopathology
Ventilator Weaning
Chemical
Reg. No./Substance:
0/Biological Agents; 0/Phospholipids; 0/Pulmonary Surfactants; 108778-82-1/beractant; KE3U2023NP/poractant alfa
Comments/Corrections
Comment In:
J Perinatol. 2010 Oct;30(10):698-9; author reply 698   [PMID:  20877366 ]
Erratum In:
J Perinatol. 2012 May;32(5):395

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


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