Comparison of the Efficacy of Three Natural Surfactants in Preterm Turkish Newborns with Respiratory Distress Syndrome

INTRODUCTION: To determine the efficacy of three natural surfactant preparations in our community and the short- and long-term results of these preterm infants.
METHODS: This was a retrospective study on 193 preterm infants with respiratory distress syndrome (RDS). The patients were divided into three groups, each of which received one of these surfactants: Group 1; beractant (100 mg/kg); Group 2; poractant alpha (first dose of 200 mg/kg, recurrent doses of 100 mg/kg); Group 3; calfactant (100 mg/kg). The groups were compared according to demographic characteristics, 1- and 5-minute Apgar scores, weight percentiles by gestational weeks, presence of pulmonary hemorrhage, surfactant dose repetition, air leak, bronchopulmonary dysplasia (BPD), stage of intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), hemodynamically significant-patent ductus arteriosus (hs-PDA) and its medical or surgical treatment, retinopathy of premature (ROP) and its treatment, sepsis, duration of invasive and non-invasive mechanical ventilation, length of free oxygen need, time to start full enteral feeding, discharge time, mortality.
RESULTS: A total of 193 preterm infants with a mean gestational age of 28.9 ± 3.1 weeks and mean birth weight of 1190.4 ± 504.3 grams. Neonates were allocated to three different groups randomly, including group-1 (n=77), group-2 (n=59), and group-3 (n=57). There were no differences in demographic and clinical characteristics of the subjects by groups. The incidence of pulmonary hemorrhage, surfactant dose repetition, air leak, duration of invasive and non-invasive mechanical ventilation, length of free oxygen need, hs-PDA and surgical treatment of PDA, BPD, NEC (≥stage II), IVH (>stage III), ROP, time to start full enteral feeding, discharge time were similar between the study groups. Sepsis and mortality were lower in Group compared to Groups 1 and 2 (p=0.015, p=0.001).
DISCUSSION AND CONCLUSION: In this study beractant, proctan alpha and calfactant had clinically similar efficacy in patients with RDS.