Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Poractant alfa and beractant treatment of very premature infants with respiratory distress syndrome

Journal of Perinatology volume 30, pages 665–670 (2010)Cite this article

Subjects

A Corrigendum to this article was published on 11 August 2011

Abstract

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 × FiO2, 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 (2/15 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.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Whitsett JA, Pryhuber GS, Rice WR, Warner BB, Wert SE . Acute respiratory disorders. In: Neonatology: Pathophysiology and Management of the Newborn. Avery GB, Fletcher MA, Macdonald MG (eds). Lippincott: Williams and Wilkins, Philadelphia, 1999, pp 485–508.

    Google Scholar 

  2. Martin JA, Hamilton BE, Sutton PD, Menacker F, Munson ML . Births: final data for 2002. National center for health statistics. Vital Health Stat 2003; 52: 1.

    Google Scholar 

  3. Lemons JA, Bauer CR, Oh W, Korones SB, Papile LA, Stoll BJ et al. Very low birth weight infant outcomes of the NICHD neonatal research network. Pediatrics 2001; 107: 1–8.

    Article  Google Scholar 

  4. Bloom BT, Kattwinkel J, Hall RT, Delmore PM, Egan EA, Trout JR et al. Comparison of Infasurf (calf lung surfactant extract) to Survanta (Beractant) in the treatment and prevention of respiratory distress syndrome. Pediatrics 1997; 100: 31–38.

    Article  CAS  PubMed  Google Scholar 

  5. Moya F, Maturana A . Animal-derived surfactants versus past and current synthetic surfactants: current status. Clin Perinatol 2007; 34: 145–177.

    Article  PubMed  Google Scholar 

  6. Speer CP, Gefeller O, Groneck P, Laufkötter E, Roll C, Hanssler L et al. Randomised clinical trial of two treatment regimens of natural surfactant preparations in neonatal respiratory distress syndrome. Arch Dis Child 1995; 72: F8–13.

    Article  CAS  Google Scholar 

  7. Baroutis G, Kaleyias J, Liarou T, Papathoma E, Hatzistamatiou Z, Costalos C . Comparison of three treatment regimens of natural surfactant preparations in neonatal respiratory distress syndrome. Eur J Pediatr 2003; 162: 476–480.

    Article  CAS  PubMed  Google Scholar 

  8. Ramanathan R, Rasmussen MR, Gerstmann D, Finer N, Sekar K, North American Study Group. A randomized, multicenter masked comparison trial of Poractant and Survanta in the treatment of respiratory distress syndrome in preterm infants. Am J Perinatol 2004; 21: 109–119.

    Article  PubMed  Google Scholar 

  9. Malloy CA, Nicoski P, Muraskas JM . A randomized trial comparing beractant and poractant treatment in neonatal respiratory distress syndrome. Acta Paediatr 2005; 94: 779–784.

    Article  PubMed  Google Scholar 

  10. Fujii AM, Allen R, Doros G, O’Brien S . Patent ductus arteriosus hemodynamics in very premature infants treated with poractant alfa or beractant for respiratory distress syndrome. J Perinatol (in press).

  11. Young TE, Mangum B . NeoFAX. 16th edn 2003. Acorn Publishing, Inc.: Raleigh, NC

    Google Scholar 

  12. Pillow JJ, Neil H, Wilkinson MH, Ramsden CA . Effect of I/E ratio on mean alveolar pressure during high-frequency oscillatory ventilation. J Appl Physiol 1999; 87: 407–414.

    Article  CAS  PubMed  Google Scholar 

  13. Richardson DK, Corcoran JD, Escobar GJ, Lee SK, for the Canadian NICU Network, The Kaiser Permanente National Minimum Data Set Wide Area Network and the SNAP-II Study Group. SNAP-II and SNAPPE-II: simplified newborn illness severity and mortality risk scores. J Pediatr 2001; 138: 92–100.

    Article  CAS  PubMed  Google Scholar 

  14. Speer CP, Robertson B, Curstedt T, Halliday HL, Compagnone D, Geffeller O et al. Randomized European multicenter trial of surfactant replacement therapy for severe neonatal respiratory distress syndrome: single versus multiple doses of Curosurf. Pediatrics 1992; 89: 13–20.

    CAS  PubMed  Google Scholar 

  15. Hammoud M, Tahlib L . Development of chronic lung disease in preterm infants treated with surfactant. Pediatr Int 2002; 44: 493–499.

    Article  CAS  PubMed  Google Scholar 

  16. Van Marter LJ, Pagano M, Allred EN, Leviton A, Kuban KC . Rate of bronchopulmonary dysplasia as a function of neonatal intensive care practices. J Pediatr 1992; 120: 938–946.

    Article  CAS  PubMed  Google Scholar 

  17. Chong E, Greenspan J, Kirkby S, Culthane J, Dysart K . Changing use of surfactant over 6 years and its relationship to chronic lung disease. Pediatrics 2008; 122: e917–e921.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, Boston University School of Medicine, Boston, MA, USA

    A M Fujii, S M Patel & R Allen

  2. Department of Biostatistics, Boston Medical Center and the Boston University School of Public Health, Boston, MA, USA

    G Doros

  3. Clinical Research Program and Program in Genomics, Childrens Hospital Boston, Boston, MA, USA

    C-Y Guo

  4. Department of Pedaitrics, Caritas St Elizabeth's Medical Center, Boston, MA, USA

    S Testa

Authors
  1. A M Fujii
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S M Patel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R Allen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G Doros
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. C-Y Guo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S Testa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A M Fujii.

Ethics declarations

Competing interests

Dr Fujii was supported by an unrestricted research grant from Dey LP, Napa, CA and Chiesi Farmaceutici Spa, Parma, Italy. The remaining authors declare no conflict of interest. The funders had no involvement in study design, in data collection, analysis/interpretation of the data, in the writing of the paper or in the decision to submit the paper for publication.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fujii, A., Patel, S., Allen, R. et al. Poractant alfa and beractant treatment of very premature infants with respiratory distress syndrome. J Perinatol 30, 665–670 (2010). https://doi.org/10.1038/jp.2010.20

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2010.20

Keywords

This article is cited by

Search

Advanced search

Quick links