Abstract
ExosurfR (Wellcome) and CurosurfR (Chiesi) are two widely used exogenous surfactants. We compared their physical and physiological properties by image analysis of microbubble stability in surfactant suspensions (1 mg/ml), mixed with various concentrations of albumin (0-40 mg/ml), and by evaluating lung structure and function in ventilated immature newborn rabbits receiving clinical treatment doses of either surfactant (Exosurf, 67.5 mg/kg; Curosurf, 160 mg/kg).
Results: Bubbles in Curosurf were significantly smaller than those in Exosurf (diameter, mean±SEM: 19±2 vs. 106±19 μm;P <0.001). Both surfactants were inhibited by albumin ≥2 mg/ml, as reflected by in- creasing microbubble diameter, but Curosurf bubbles remained smaller than Exosurf bubbles at albumin concentrations ≤4 mg/ml. Lung-thorax compliance after 1 h was significantly greater in Curosurf-treated animals (mean±SEM: 0.62±0.05 ml/cmH2O.kg) than in littermates receiving Exosurf (0.45±0.01) or controls (0.44±0.06)(P <0.05). Airway epithelium of Curosurf-treated animals was mostly intact, whereas Exosurf-treated and control animals had widespread epithelial injury.
Conclusions: Curosurf stabilizes microbubbles better than Exosurf, even in the presence of low concentrations of albumin. Curosurf is more effective than Exosurf when given in clinical treatment doses to ventilated immature rabbits.
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Berggren, P., Corcoran, D., Curstedt, T. et al. EXOSURF VERSUS CUROSURF; COMPARISON OF SURFACE PROPERTIES, RESISTANCE TO INHIBITION, AND PHYSIOLOGICAL EFFECTS IN PRETERM RABBITS. Pediatr Res 32, 634 (1992). https://doi.org/10.1203/00006450-199211000-00179
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DOI: https://doi.org/10.1203/00006450-199211000-00179