Effectiveness of three types of exogenous surfactant in preterm infants with hyaline membrane disease

Abstract

Introduction: Hyaline membrane disease is an important cause of neonatal mortality.

The objective of this research is to evaluate the efficacy of three different exogenous surfactants in premature infants. 

Patients and Method: A retrospective cohort analysis in 93 preterm infants ≥ 24 weeks and birth weight ≥ 500 g was performed, 31 infants for each surfactant. Exposure consisted of the 1st dose of bovactant (Alveofact^®) 50 mg/kg, beractant (Survanta^®) 100 mg/kg initially, and poractant alfa (Curosurf^®) 200 mg/kg. The variables included duration of mechanical ventilation, duration of oxygen therapy, hospital stay, need for second dose of surfactant, adverse events surfactant administration and prematurity complications. Mortality and bronchopulmonary dysplasia (BPD) were evaluated. Statistical analysis was performed using Stata^® 11.0, X² or Fisher exact test for qualitative variables and ALNOVA or Kruskal-Wallis tests for quantitative and association relative risk, all with 95% confidence level. 

Results: There were no gender, weight and gestational age differences at birth among the three groups. No statistically significant differences were found regarding duration of mechanical ventilation, duration of oxygen therapy, administration of a second dose of surfactant, hospital stay and complications among the three groups. Adverse events related to surfactant administration occurred for beractant and poractant alpha. There were 30 (32.3%) deaths, 8 (25.8%) associated to bovactant, 10 (32.3%) to beractant and 12 (38.7%) to poractant alpha (p > 0.05). Mortality and/or BDP occurred in 10 (32.2%) infants who received bovactant, 10 (32.2%) beractant and 14 (45.2%) with poractant alpha (p > 0.05). 

Conclusions: The primary and secondary outcomes among the three surfactants tested were similar, taking into account the limitations of the work.