Efficacy of Surfactant-TA, Calfactant and Poractant Alfa for Preterm Infants with Respiratory Distress Syndrome: A Retrospective Study

• Published in: Yonsei medical journal Vol. 56; no. 2; pp. 433 - 439
• Main Authors: Jeon, Ga Won, Oh, Minkyung, Sin, Jong Beom
• Format: Journal Article
• Language: English
• Published: Korea (South) Yonsei University College of Medicine 01.03.2015; 연세대학교의과대학
• Subjects: Biological Products - administration & dosage; Biological Products - therapeutic use; Birth Weight; Bronchopulmonary Dysplasia - drug therapy; Female; Gestational Age; Humans; Infant, Newborn; Infant, Premature; Male; Original; Phospholipids - administration & dosage; Phospholipids - therapeutic use; Pulmonary Surfactants - administration & dosage; Pulmonary Surfactants - therapeutic use; Republic of Korea; Respiration, Artificial; Respiratory Distress Syndrome, Newborn - drug therapy; Retrospective Studies; Risk; Treatment Outcome; Ventilator Weaning; 의학일반; Pulmonary surfactants; respiratory distress syndrome; poractant alfa; beractant; calfactant
• ISSN: 0513-5796; 1976-2437; 1976-2437
• DOI: 10.3349/ymj.2015.56.2.433

To compare the efficacy of the new drug calfactant with the commonly used drugs surfactant-TA and poractant alfa. A total of 332 preterm infants at 24-31 weeks' gestation with respiratory distress syndrome (RDS) were enrolled and allocated to three groups according to the surfactant instilled; Group 1 (n=146, surfactant-TA), Group 2 (n=96, calfactant), and Group 3 (n=90, poractant alfa). The diagnosis of RDS and the decision to replace the pulmonary surfactant were left to the attending physician and based on patient severity determined by chest radiography and blood gas analysis. Data were collected and reviewed retrospectively using patient medical records. Demographic factors including gestational age, birth weight, Apgar score, clinical risk index for babies II score, and maternal status before delivery were not different between the study groups. Instances of surfactant redosing and pulmonary air leaks, as well as duration of mechanical ventilation, were also not different. Rates of patent ductus arteriosus, intraventricular hemorrhage (≥grade III), periventricular leukomalacia, high stage retinopathy of prematurity, necrotizing enterocolitis (≥stage II), and mortality were also similar, as was duration of hospital stay. Cases of pulmonary hemorrhage and moderate to severe bronchopulmonary dysplasia were increased in Group 3. Calfactant is equally as effective as surfactant-TA and poractant alfa. This was the first study comparing the efficacy of surfactant-TA, calfactant, and poractant alfa in a large number of preterm infants in Korea. Further randomized prospective studies on these surfactants are needed.