Natural Versus Synthetic Surfactant Therapy in Respiratory Distress Syndrome of Prematurity

Indian J Pediatr. 2022 Nov;89(11):1086-1092. doi: 10.1007/s12098-022-04166-4. Epub 2022 Jun 1.

Abstract

Objectives: To compare the clinical efficacy and the cost of treatment between the newborns who received either a natural or a protein-free synthetic surfactant for respiratory distress syndrome (RDS) of prematurity.

Methods: This is a retrospective analytical study incorporating comparisons of clinical parameters and cost in newborns having RDS of prematurity who received either Survanta (bovine lung extract), a natural surfactant or Surfact (protein-free colfosceril palmitate), a synthetic surfactant.

Results: There were 100 newborns who received either of the natural (n = 52) or synthetic (n = 48) surfactant with mean (SD) gestational age and mean (SD) birth weight of 31.5 (2.6) wk, 1425 (461) g and 32.2 (2.2) wk, 1519 (413) g, respectively. Majority of the newborns (> 90%) received endotracheal surfactant within the first 24 h of life and had similar baseline characteristics in either group. No differences were noted in ventilator settings on admission and 24 h after surfactant/admission. Oxygen requirement, extubation age, complications, hospital stay, and mortality were similar across groups, except that the necrotizing enterocolitis was noted only in natural surfactant group. There was a significant pharmacy cost savings in synthetic surfactant group.

Conclusion: Synthetic surfactant was comparable to natural surfactant with regard to outcomes, like ventilator settings, hospital stay, and mortality. Pharmacy cost was less in synthetic surfactant group.

Keywords: Artificial surfactant; Hyaline membrane disease; Mechanical ventilation; Neonatal intensive care unit; Newborn; Oxygen.

MeSH terms

  • Animals
  • Cattle
  • Humans
  • Infant, Newborn
  • Infant, Premature, Diseases*
  • Oxygen
  • Pulmonary Surfactants* / therapeutic use
  • Respiratory Distress Syndrome, Newborn* / drug therapy
  • Retrospective Studies
  • Surface-Active Agents / therapeutic use

Substances

  • Pulmonary Surfactants
  • Surface-Active Agents
  • Oxygen