Baroutis Georgios, Kaleyias Joseph, Liarou Theodora, Papathoma Eugenia, Hatzistamatiou Zoe, Costalos Christos
Department of Neonatal Medicine, General District Hospital "Alexandra", Athens, Greece.
, 31 Atho Street, 26226, Patra, Greece.
Eur J Pediatr. 2003 Jul;162(7-8):476-480. doi: 10.1007/s00431-002-1144-0. Epub 2003 Apr 23.
The aim of the study was to compare the treatment regimen of three natural surfactants of different extraction and formulation (Alveofact [Surfactant A = SA], Poractant [Surfactant B = SB] and Beractant [Surfactant C = SC]) in neonatal respiratory distress syndrome (RDS). Premature infants of </=32 weeks' gestation with birth weight of </=2,000 g and with established RDS requiring artificial ventilation with a FiO2 >/=0.3 were randomly assigned to receive at least two doses of SA, SB or SC (100 mg/kg per dose). Infants who remained dependent on artificial ventilation with a FiO2 >/=0.3 received up to two additional doses. There were no differences among the groups regarding the necessity for more than two doses. The SA and the SB groups spent fewer days on a ventilator (p-value SA/SB 0.7, SA/SC 0.05, SB/SC 0.043) compared with the SC group, needed fewer days of oxygen administration (p-value SA/SB 0.14, SA/SC 0.05, SB/SC 0.04) and spent fewer days in hospital (p-value SA/SB 0.65, SA/SC 0.04, SB/SC 0.027). There were no statistically significant differences in the incidence of mortality, chronic lung disease, air leaks, necrotising enterocolitis, retinopathy of prematurity and intraventricular haemorrhage among the three groups.
The Alveofact and Poractant groups spent fewer days on the ventilator, needed fewer days of oxygen administration and spent fewer days in hospital compared with the Beractant group but no differences were observed among the three groups with regards to mortality and morbidity.
本研究的目的是比较三种不同提取和配方的天然表面活性剂(肺泡表面活性物质[表面活性剂A = SA]、猪肺磷脂[表面活性剂B = SB]和固尔苏[表面活性剂C = SC])在新生儿呼吸窘迫综合征(RDS)中的治疗方案。孕周≤32周、出生体重≤2000g且确诊为RDS需要使用≥0.3的吸入氧分数进行人工通气的早产儿被随机分配接受至少两剂SA、SB或SC(每剂100mg/kg)。仍依赖≥0.3的吸入氧分数进行人工通气的婴儿可额外接受最多两剂。在需要超过两剂的必要性方面,各组之间没有差异。与SC组相比,SA组和SB组在呼吸机上的天数更少(SA/SB的p值为0.7,SA/SC为0.05,SB/SC为0.043),需要吸氧的天数更少(SA/SB的p值为0.14,SA/SC为0.05,SB/SC为0.04),住院天数更少(SA/SB的p值为0.65,SA/SC为0.04,SB/SC为0.027)。三组之间在死亡率、慢性肺病、气漏、坏死性小肠结肠炎、早产儿视网膜病变和脑室内出血的发生率方面没有统计学上的显著差异。
与固尔苏组相比,肺泡表面活性物质组和猪肺磷脂组在呼吸机上的天数更少,需要吸氧的天数更少,住院天数更少,但在死亡率和发病率方面,三组之间未观察到差异。