Comparison between two natural surfactant poractant alfa and bovine lipid extract in respiratory distress syndrome amongst preterm neonates-a quasi-experimental study

Srikanta Baske, Sudip Saha, Partha Pratim Pal


Background: A comparison study of two natural surfactants in preterm babies admitted in neonatal intensive care unit (NICU) and sick newborn care unit (SNCU) of a tertiary care hospital to find out efficacy and consequences.

Methods: A Quasi-experimental study. InSurE technique applied for administering Poractant alfa (CUROSURF) and bovine surfactant (NEOSURF) in two comparison group of preterm neonates with respiratory distress syndrome (RDS) during May 2018 to April 2019. The need of mechanical ventilation, oxygen requirement (FiO2), duration of oxygen requirement and the consequences were assessed.

Results: The CUROSURF is 6.67% more efficacious than NEOSURF in respect to less requirement of mechanical ventilation. The differences were found between two groups in terms of FiO2adjusted (33.49% vs 37.17%) and common side effects respectively but the difference of mean duration of oxygenation (69.8 hrs vs 111.9 hrs) was less and statistically significant in CUROSURF group. Mean duration of hospitalization (9.55 day’s vs 14.9 days) also were found to be less and statistically significant.

Conclusions: Treatment with CUROSURF was associated with faster improving oxygenation, less additional doses, and decreased need of mechanical ventilation.


Quasi-experimental, InSurE, Mechanical ventilation, Oxygen requirement, Natural surfactants

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Slattery MM, Morrison JJ. Preterm delivery. Lancet. 2002;360:1489-97.

Callaghan WM, MacDorman MF, Rasmussen SA, Qin C, Lackritz EM. The contribution of preterm birth to infant mortality in the United States. Pediatrics. 2006;118:1566-73.

Chard T, Soe A, Costeloe K. The risk of neonatal death and respiratory distress syndrome in relation to birth weight of preterm infants. Am J Perinatol. 1997;14:523-26.

Liechty EA, Donovan E, Purohit D. Reduction of neonatal mortality after multiple doses of bovine surfactant in low-birth-weight neonates with respiratory distress syndrome. Pediatrics. 1991,88:19-28.

Ramanathan R, Rasmussen MR, Gerstmann DR, Finer N, Sekar K. North American Study Group. A randomized, multicenter masked comparison trial of poractant alfa (CUROSURF) versus beractant (survanta) in the treatment of respiratory distress syndrome in preterm infants. Am J Perinatol. 2004;21:109-19.

Sweet DG, Carnielli V, Greisen G, Hallman M, Ozek E, Plavka R et al. European consensus guidelines on the management of neonatal respiratory distress syndrome in preterm infants-2013 update. Neonatology. 2013,103:353-68.

Collaborative European Multicenter Study Group. Surfactant replacement therapy for severe neonatal respiratory distress syndrome: an international randomized clinical trial. Pediatrics. 1988;82:683-91.

Speer CP, Robertson B, Curstedt T, Halliday HL, Compagnone D, Gefeller O et al. Randomized European multicenter trial of surfactant replacement therapy for severe neonatal respiratory distress syndrome: single versus multiple doses of CUROSURF. Pediatrics. 1992;89:13-20.

Speer CP, Reu BD, Harms K, Herting E, Gefeller O. Neutrophil elastase and acute pulmonary damage in infants with severe respiratory distress syndrome. Pediatrics. 1993;91:794-9.

Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr. 1978,92:529-34.

Kienstra KA. Pulmonary hemorrhage. In: Cloherty JP, Eichenwald EC, Hansen AR, Stark AR. (eds.). Manual of neonatal care. 7th edition. New Delh: Wolters Kluwer (India) Pvt Ltd. 2017;443.

Speer CP, Rethwilm M, Gahr M. Elastaseoal proteinaseinhibitor: an early indicator of septicemia and bacterialmeningitis in children. J Pediatr. 1987;111:667-71.

Baroutis G, Kaleyias J, Liarou T, Papathoma E, Hatzistamatiou Z, Costalos C. Comparison of three treatment regimens of natural surfactant preparations in neonatal respiratory distress syndrome. Eur J Pediatr. 2003;162(7-8):476-80.

Saeidi R, Hamedi A, Javadi A. Comparison of side effect of survanta and CUROSURF in decreasing mortality due to respiratory distress syndrome (RDS) in premature infants admitted in NICU of Ghaem Hospital On 2006-2008. Ir J Neonatol. 2013;4:7-12.

Malloy CA, Nicoski P, Muraskas JK. A randomized trial comparing beractant and poractant treatment in neonatal respiratory distress syndrome. Acta Paediatr. 2005;94(6):779-84.

Mussavi M, Mirnia K, Asadollahi K. Comparison of the efficacy of three natural surfactants (CUROSURF, Survanta, and Alveofact) in the treatment of respiratory distress syndrome among neonates: a randomized controlled trial. Iran J Pediatr. 2016;26(5):e5743.

Brown S, Hurren J, Sartori H. Poractant Alfa Versus Beractant for Neonatal Respiratory Distress Syndrome: A Retrospective Cost Analysis. J Pediatr Pharmacol Ther. 2018;23(5):367-71.