Reduction of neonatal mortality after multiple doses of bovine surfactant in low birth weight neonates with respiratory distress syndrome

Infants born prematurely often suffer from lung problems such as respiratory distress syndrome that increase their risk of illness and death above that of full-term infants. Premature infants lack a substance called surfactant in the lungs which is essential for respiratory function. In the past decade, it was found that a surfactant derived from cows (bovine surfactant) could be given to these infants, and that this decreased the need for oxygen and ventilation (use of a breathing machine). Further studies found that a single dose given at birth reduced the severity of the symptoms of respiratory distress syndrome, but did not necessarily increase survival rates. This study examined if giving more than a single dose of the surfactant when disease persisted would increase survival rates in these infants. The study involved 798 infants born prematurely weighing between 600 and 1,750 grams (1.3 and 3.9 pounds) that developed respiratory distress syndrome within six hours after birth. The infants were randomly assigned to one of two groups; one was the control group (396 infants) and the other received an initial dose of the surfactant with repeated doses if needed (402 infants). Results showed that in the first 28 days after birth, 36 treated infants (9 percent) and 80 untreated infants (20 percent) died from respiratory distress syndrome. Deaths from all causes during this period were 74 (18 percent) in the treated group and 108 (27 percent) in the untreated group. Mean airway pressure and oxygenation values, measures of respiratory function, during the first 72 hours of life were significantly better in the treated than in the untreated infants. The treated infants also developed significantly fewer cases of pulmonary interstitial emphysema and of pulmonary air leaks than the untreated infants. These results indicate that multiple doses of bovine surfactant given to premature infants with respiratory distress syndrome can reduce the incidence of illness and death. (Consumer Summary produced by Reliance Medical Information, Inc.)