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Poractant alfa versus bovine lipid extract surfactant: prospective comparative effectiveness study

Journal of Perinatology volume 42, pages 468–475 (2022)Cite this article

Subjects

Abstract

Objective

To compare short term respiratory outcomes in preterm infants treated with bovine lipid extract surfactant or poractant alfa.

Study design

Prospective comparative effectiveness cohort study of infants <32 weeks’ gestational age requiring surfactant in thirteen centers. Each center provided bovine lipid extract surfactant for a set period of time in the year 2019 and then changed to poractant alfa for the remainder of the year. The primary outcome was total duration of respiratory support.

Result

968 infants were included. 494 received bovine lipid extract surfactant and 474 received poractant alfa. No difference was observed in the total duration of respiratory support (mechanical ventilation or non-invasive) (median 38 vs 40.5 days), need to re-dose surfactant, bronchopulmonary dysplasia, survival to discharge, or length of admission.

Conclusion

In this pragmatic study, we did not identify any difference in short term outcomes between the groups based on the type of surfactant received.

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Fig. 1: Flow diagram of patients included in the study.

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Data availability

The data sets generated and analyzed during the current study are with the corresponding author but current data transfer approval agreements do not allow for data to be available to others.

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Acknowledgements

Authors would like to acknowledge the contribution of Dr. Petros Pechlivanoglou for his statistical input.

Funding

Although no specific funding was received for this study, organizational support for the Canadian Neonatal Network was provided by the Maternal-infant Care Research Centre (MiCare) at Mount Sinai Hospital in Toronto, Ontario, Canada. MiCare is supported by a Canadian Institutes of Health Research (CIHR) Team Grant (CTP 87518), the Ontario Ministry of Health and Long-Term Care, and the participating hospitals. PSS holds a CIHR Applied Research Chair in Reproductive and Child Health Services and Policy Research (APR-126340). Additionally, Metapharm Specialty Pharmaceuticals provided poractant alfa at the same cost per mL as bovine lipid extract surfactant to participating sites, for the duration of the study, but had no involvement in design, conduct of analyses, interpretation and reporting of the results. The funding bodies played no role in the design and conduct of the study; the collection, management, analysis, and interpretation of the data; the preparation, review, and approval of the manuscript; or the decision to submit the manuscript for publication.

Author information

Authors and Affiliations

  1. Division of Neonatology, Children’s Hospital of Eastern Ontario, Ottawa, Canada

    Brigitte Lemyre

  2. Department of Obstetrics, Gynecology and Newborn care, The Ottawa Hospital, Ottawa, Canada

    Brigitte Lemyre

  3. Department of Pediatrics, Section of Neonatology, Cumming School of Medicine, University of Calgary, Calgary, Canada

    Thierry Lacaze-Masmonteil & Stefanie Doucette

  4. Department of Pediatrics, Mount Sinai Hospital and University of Toronto, Toronto, Canada

    Prakesh S. Shah & Xiang Y. Ye

  5. Regina General Hospital, Department of Pediatrics, College of Medicine, University of Saskatchewan, Regina, Canada

    Jaya Bodani

  6. Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Center, Toronto, Canada

    Michael Dunn

  7. Department of Pediatrics, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada

    Deepak Louis

  8. Saint John Regional Hospital, Saint John, Canada

    Luis Monterrosa

  9. Department of Pediatrics, Division of Neonatology, McMaster University, Hamilton, Canada

    Amit Mukerji

  10. Division of Neonatology, University of Alberta, Edmonton, Canada

    Georg M. Schmölzer

  11. Department of Pediatrics, Dalhousie University, Halifax, Canada

    Balpreet Singh

  12. Department of Pediatrics, Division of Neonatology, University of British Columbia, Vancouver, Canada

    Jonathan Wong

  13. Department of Pediatrics, University of Toronto, Toronto, Canada

    Martin Offringa

Authors
  1. Brigitte Lemyre
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  2. Thierry Lacaze-Masmonteil
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  3. Prakesh S. Shah
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  4. Jaya Bodani
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  5. Stefanie Doucette
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  6. Michael Dunn
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  7. Deepak Louis
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  8. Luis Monterrosa
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  9. Amit Mukerji
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  10. Georg M. Schmölzer
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  11. Balpreet Singh
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  12. Jonathan Wong
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  13. Xiang Y. Ye
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  14. Martin Offringa
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Contributions

BL, TL, MO, and PSS conceptualized and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript. JB, SD, MD, DL, LM, AM, GMS, BS, and JW participated in study design and data interpretation, and reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work in ensuring that questions related to its accuracy or integrity are appropriately investigated and resolved.

Corresponding author

Correspondence to Brigitte Lemyre.

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The authors declare no competing interests.

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Lemyre, B., Lacaze-Masmonteil, T., Shah, P.S. et al. Poractant alfa versus bovine lipid extract surfactant: prospective comparative effectiveness study. J Perinatol 42, 468–475 (2022). https://doi.org/10.1038/s41372-022-01346-0

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  • DOI: https://doi.org/10.1038/s41372-022-01346-0

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