Comparative Effectiveness of Surfactant Preparations in Premature Infants

Overview

Journal J Pediatr

Specialty Pediatrics

Date 2013 Jun 18

PMID 23769501

Citations 39

Authors

Andrea Trembath

Christoph P Hornik

Reese Clark

P Brian Smith

Julie Daniels

Matthew Laughon

Affiliations

Soon will be listed here.

Abstract

Objective: To compare effectiveness of 3 surfactant preparations (beractant, calfactant, and poractant alfa) in premature infants for preventing 3 outcomes: (1) air leak syndromes; (2) death; and (3) bronchopulmonary dysplasia (BPD) or death (composite outcome).

Study Design: We conducted a comparative effectiveness study of premature infants admitted to 322 neonatal intensive care units in the US from 2005-2010 who were treated with beractant, calfactant, or poractant alfa. We compared the incidence of air leak syndromes, death, and BPD or death, adjusting for gestational age (GA), antenatal steroids, discharge year, and small for GA status.

Results: A total of 51282 infants received surfactant; 40% received beractant, 30% calfactant, and 30% poractant alfa. Median birth weight was 1435 g (IQR 966-2065); median GA was 30 weeks (27-33). On adjusted analysis, we observed a similar risk of air leak syndromes (calfactant vs beractant OR = 1.17 [95% CI: 0.95, 1.43]; calfactant vs poractant OR = 1.23 [0.98, 1.56]; beractant vs poractant OR = 1.06 [0.87, 1.29]), death (calfactant vs beractant OR = 1.14 [0.93, 1.39]; calfactant vs poractant OR = 0.98 [0.78, 1.23]; beractant vs poractant OR = 0.86 [0.72, 1.04]), and BPD or death (calfactant vs beractant OR = 1.08 [0.93, 1.26]; calfactant vs poractant OR = 1.19 [1.00, 1.41]; beractant vs poractant OR = 1.10 [0.96, 1.27]).

Conclusions: Beractant, calfactant, and poractant alfa demonstrated similar effectiveness in prevention of air leak syndromes, death, and BPD or death in premature infants when adjusted for site. Previously described differences in mortality between surfactants likely do not represent true differences in effectiveness but may relate to site variation in outcomes.

Citing Articles

Comparison of Efficacy and Pharmacoeconomic Outcomes Between Calfactant and Poractant Alfa in Preterm Infants With Respiratory Distress Syndrome.

Bui A, Schumann C, Le J, Jones T, Schwendeman C J Pediatr Pharmacol Ther. 2024; 29(3):241-247.

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[Impact of different angles of pulmonary surfactant administration on bronchopulmonaryplasia and intracranial hemorrhage in preterm infants: a prospective randomized controlled study].

Dai X, Zhu A, Xie T, Xiong Y, Meng L, Chen M Zhongguo Dang Dai Er Ke Za Zhi. 2024; 26(4):337-342.

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Comparison of efficacy between beractant and poractant alfa in respiratory distress syndrome among preterm infants (28-33 weeks gestational age) using the less invasive surfactant administration (LISA) technique: A randomized controlled trial.

Zamal A, Sk M, Saha B, Hazra A J Perinatol. 2024; .

PMID: 38609483 DOI: 10.1038/s41372-024-01962-y.

Prescribing practices of inhaled corticosteroids for premature infants in the neonatal intensive care unit.

Tang M, Ibrahim A, Laughon C, Moore K, Tejada A, Tran D J Perinatol. 2024; 44(7):953-956.

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A clinical study evaluating the combination of LISA and SNIPPV for the treatment of respiratory distress syndrome in preterm infants.

Permall D, Zhang Y, Li H, Guan Y, Chen X Sci Rep. 2024; 14(1):1429.

PMID: 38228632 PMC: 10792160. DOI: 10.1038/s41598-023-50303-0.

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