COMPARISON OF 2 BOVINE SURFACTANT PREPARATIONS IN THE TREATMENT OF RESPIRATORY-DISTRESS-SYNDROME IN PREMATURES

Object: To compare the efficacy of two commercially available bovine surfactant preparations. Methods: Between february 1990 and september 1993 we treated 134 premature newborns with respiratory distress syndrome with one of the two bovine surfactant preparations (Alveofact, Fa. Thomae; Survanta, Fa. Abbott). Among these patients we were able to identify 38 pairs of patients from both groups with similar gestational age, birth weight, and radiological degree of respiratory distress syndrome. The records of these patients were analyzed retrospectively with regard to mortality and morbidity and to the response to the surfactant substitution. Time of the first surfactant dose was similar in both groups. Results: There was no difference between the groups in mortality, the incidence of neonatal morbidity and in the duration of assisted ventilation or supplemental oxygen administration. Six patients showed no or poor response to surfactant treatment. During the first hours after the first surfactant dose the average FiO(2) was significantly lower in the Alveofact group. But during the following hours 50% of the Alveofact treated infants showed a relapse and were treated again whereas only 13.3% of Survanta treated infants needed a second dose. The average amount of surfactant was 114.2 +/- 36.7 mg/kg body weight in the Survanta treated group and 229.3 +/- 154.4 mg/kg body weight in the Alveofact treated group. Conclusion: We found no difference between the two groups with regard to the incidence of death or neonatal morbidities, although there was a significant difference in the initial response to treatment and in the number and dose of surfactant substitutions.