Sekar Krishnamurthy, Fuentes Daniel, Krukas-Hampel Michelle R, Ernst Frank R
J Pediatr Pharmacol Ther. 2019 Mar-Apr;24(2):117-127. doi: 10.5863/1551-6776-24.2.117.
To compare length of stay (LOS), costs, mechanical ventilation (MV), and mortality in preterm infants treated in the Neonatal Intensive Care Unit (NICU) with beractant (BE), calfactant (CA), and poractant alfa (PA) for Respiratory Distress Syndrome (RDS).
This study evaluated preterm infants born between 2010 and 2013 with RDS diagnosis, gestational age of 25 to 36 weeks, birthweight of ≥500 g, and age of ≤2 days on first surfactant administration. Multivariable regression was used to evaluate all NICU outcomes.
Of 13,240 infants meeting the study criteria, 4136 (31.2%) received BE, 2502 (18.9%) received CA, and 6602 (49.9%) received PA. Adjusted analyses estimated similar mean LOS (BE 26.7 days, CA 27.8 days, and PA 26.2 days) and hospital costs (BE: $50,929; CA: $50,785; and PA: $50,212). Compared to PA, BE and CA were associated with greater odds of MV use on day 3 (OR = 1.56 and 1.60, respectively) and day 7 (OR = 1.39 and 1.28, respectively; all p < 0.05). Adjusted NICU mortality was significantly higher only with CA vs PA (OR = 1.51; p = 0.015).
Adjusted NICU LOS and costs were similar among BE, CA, and PA. Infants receiving PA were less likely to be on MV at 3 and 7 days, and PA treatment was associated with lower odds of NICU mortality when compared to CA.
比较在新生儿重症监护病房（NICU）接受贝拉克坦（BE）、卡富康（CA）和猪肺磷脂（PA）治疗呼吸窘迫综合征（RDS）的早产儿的住院时间（LOS）、费用、机械通气（MV）情况及死亡率。
本研究评估了2010年至2013年出生、诊断为RDS、胎龄为25至36周、出生体重≥500g且首次使用表面活性剂时年龄≤2天的早产儿。采用多变量回归评估所有NICU结局。
在13240名符合研究标准的婴儿中，4136名（31.2%）接受了BE，2502名（18.9%）接受了CA，6602名（49.9%）接受了PA。校正分析估计平均住院时间相似（BE为26.7天，CA为27.8天，PA为26.2天），医院费用也相似（BE：50929美元；CA：50785美元；PA：50212美元）。与PA相比，BE和CA在第3天（OR分别为1.56和1.60）和第7天（OR分别为1.39和1.28；均p<0.05）使用MV 的几率更高。校正后的NICU死亡率仅CA与PA相比显著更高（OR = 1.51；p = 0.015）。
BE、CA和PA之间校正后的NICU住院时间和费用相似。接受PA治疗的婴儿在第3天和第7天接受MV治疗的可能性较小，与CA相比，PA治疗的NICU死亡率几率更低。
