A retrospective study of 24,883 premature babies with respiratory distress syndrome treated in 191 U.S. hospitals from January 2003 to June 2006 showed reduced mortality for all causes in babies given poractant alfa, according to lead researcher Dr. Jatinder Bhatia, chief of the Section of Neonatology at the Medical College of Georgia in Augusta. “The differences hold true whether you are sitting in a rural hospital or teaching hospital or non-teaching hospital.”
The study was the first to compare all three natural surfactants used in this country to treat babies with respiratory distress syndrome. Previous studies, comparing poractant alfa with calf-derived beractant, have yielded similar results; studies comparing beractant and calfactant, also calf-derived, demonstrated no differences in mortality. The smaller studies prompted researchers to do their more comprehensive review.
Their results are being presented May 7 during the Pediatric Academic Societies Annual Meeting in Toronto.
“We are looking at a large, vulnerable population and we need this kind of data to make informed decisions,” Dr. Bhatia says. He notes that the current analysis doesn’t explain differences in mortality so additional studies might be needed.
About 12.7 percent of babies are born prematurely in the United States annually and about 30,000-40,000 babies have respiratory distress with surfactant deficiency.
“It’s inversely related to gestational age and birth weight: the younger the baby, the higher the percentage of these babies that have little or no surfactant,” says Dr. Bhatia.
Surfactant is a viscous, soapy-like substance that keeps thousands of air sacs inside the lungs from sticking together when they inflate and deflate while breathing. “If you think of the lungs as a million little balloons, these balloons collapse when the baby tries to breathe out and that is why they get into respiratory distress,” says Dr. Bhatia.
Premature lungs don’t immediately produce the essential lubricant, and air sacs are quickly damaged trying to function without it, even with ventilator support.
Neonatologists try to prevent damage by giving surfactant within the first hour after birth to tide the baby over until his own lungs start producing it some 48 hours later, Dr. Bhatia says. Prescribed surfactant will eventually become part of the baby’s endogenous pool.
“We can give surfactant of a similar composition as Mother Nature would have made to help ameliorate the disease process. The basic premise is to give surfactant as early as possible to prevent the baby’s lungs from collapsing. Once they collapse, it takes greater support from the outside to reopen these units,” Dr. Bhatia says.
The surfactant effect is almost instantaneous. In fact, neonatologists are increasingly taking babies off the ventilator at the same time surfactant is given. Prenatal steroids, which accelerate lung maturity, are given to mothers when premature birth is imminent. Lung-sparing measures, such as the lowest possible ventilator setting, also are used.
Pig-derived poractant alfa, a relative newcomer approved by the FDA in 1999, was the least-used surfactant in the study population. Of the 24,883 babies in the data base provided by Charlotte, N.C.-based Premier Inc. 4,953 got poractant alfa, marketed as Curosurf®; 12,653 got beractant marketed as Survanta®; and 7,277 got calfactant, marketed as Infasurf®.
Co-authors on the study included researchers at Women’s and Children’s Hospital in Los Angeles and the University of Oklahoma Health Sciences Center in Oklahoma City.
The study was funded by Dey, L.P. and Chiesi Farmaceutici of Parma, Italy, which market and make poractant alfa. None of the researchers have financial interests in either company.
Toni Baker | EurekAlert!
Europe’s Demographic Future. Where the Regions Are Heading after a Decade of Crises
10.08.2017 | Berlin-Institut für Bevölkerung und Entwicklung
Scientists reveal source of human heartbeat in 3-D
07.08.2017 | University of Manchester
Whether you call it effervescent, fizzy, or sparkling, carbonated water is making a comeback as a beverage. Aside from quenching thirst, researchers at the University of Illinois at Urbana-Champaign have discovered a new use for these "bubbly" concoctions that will have major impact on the manufacturer of the world's thinnest, flattest, and one most useful materials -- graphene.
As graphene's popularity grows as an advanced "wonder" material, the speed and quality at which it can be manufactured will be paramount. With that in mind,...
Physicists at the University of Bonn have managed to create optical hollows and more complex patterns into which the light of a Bose-Einstein condensate flows. The creation of such highly low-loss structures for light is a prerequisite for complex light circuits, such as for quantum information processing for a new generation of computers. The researchers are now presenting their results in the journal Nature Photonics.
Light particles (photons) occur as tiny, indivisible portions. Many thousands of these light portions can be merged to form a single super-photon if they are...
For the first time, scientists have shown that circular RNA is linked to brain function. When a RNA molecule called Cdr1as was deleted from the genome of mice, the animals had problems filtering out unnecessary information – like patients suffering from neuropsychiatric disorders.
While hundreds of circular RNAs (circRNAs) are abundant in mammalian brains, one big question has remained unanswered: What are they actually good for? In the...
An experimental small satellite has successfully collected and delivered data on a key measurement for predicting changes in Earth's climate.
The Radiometer Assessment using Vertically Aligned Nanotubes (RAVAN) CubeSat was launched into low-Earth orbit on Nov. 11, 2016, in order to test new...
A study led by scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg presents evidence of the coexistence of superconductivity and “charge-density-waves” in compounds of the poorly-studied family of bismuthates. This observation opens up new perspectives for a deeper understanding of the phenomenon of high-temperature superconductivity, a topic which is at the core of condensed matter research since more than 30 years. The paper by Nicoletti et al has been published in the PNAS.
Since the beginning of the 20th century, superconductivity had been observed in some metals at temperatures only a few degrees above the absolute zero (minus...
16.08.2017 | Event News
04.08.2017 | Event News
26.07.2017 | Event News
23.08.2017 | Life Sciences
23.08.2017 | Life Sciences
23.08.2017 | Physics and Astronomy