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!
When a fish becomes fluid
17.12.2018 | Institute of Science and Technology Austria
Some brain tumors may respond to immunotherapy, new study suggests
11.12.2018 | Columbia University Irving Medical Center
Researchers from the University of Basel have reported a new method that allows the physical state of just a few atoms or molecules within a network to be controlled. It is based on the spontaneous self-organization of molecules into extensive networks with pores about one nanometer in size. In the journal ‘small’, the physicists reported on their investigations, which could be of particular importance for the development of new storage devices.
Around the world, researchers are attempting to shrink data storage devices to achieve as large a storage capacity in as small a space as possible. In almost...
The more objects we make "smart," from watches to entire buildings, the greater the need for these devices to store and retrieve massive amounts of data quickly without consuming too much power.
Millions of new memory cells could be part of a computer chip and provide that speed and energy savings, thanks to the discovery of a previously unobserved...
What if, instead of turning up the thermostat, you could warm up with high-tech, flexible patches sewn into your clothes - while significantly reducing your...
A widely used diabetes medication combined with an antihypertensive drug specifically inhibits tumor growth – this was discovered by researchers from the University of Basel’s Biozentrum two years ago. In a follow-up study, recently published in “Cell Reports”, the scientists report that this drug cocktail induces cancer cell death by switching off their energy supply.
The widely used anti-diabetes drug metformin not only reduces blood sugar but also has an anti-cancer effect. However, the metformin dose commonly used in the...
A research team from the University of Zurich has developed a new drone that can retract its propeller arms in flight and make itself small to fit through narrow gaps and holes. This is particularly useful when searching for victims of natural disasters.
Inspecting a damaged building after an earthquake or during a fire is exactly the kind of job that human rescuers would like drones to do for them. A flying...
12.12.2018 | Event News
10.12.2018 | Event News
06.12.2018 | Event News
18.12.2018 | Materials Sciences
18.12.2018 | Physics and Astronomy
18.12.2018 | Physics and Astronomy