Article Text

EFFECT OF 100 VERSUS 200 MG/KG OF PORCINE SURFACTANT ON DISATURATED PHOSPHATIDYLCHOLINE KINETICS IN PRETERM INFANTS WITH RESPIRATORY DISTRESS SYNDROME
  1. M Facco Marcazzo1,
  2. P E Cogo1,
  3. M Simonato1,
  4. G Verlato1,
  5. C Rondina2,
  6. G Martiri2,
  7. I Burattini2,
  8. G M Toffolo3,
  9. V P Carnielli2
  1. 1Department of Pediatrics, University of Padova, Padova, Italy
  2. 2Neonatal Division, Institute of Maternal-Infantile Sciences, Polytechnic University of Marche, Salesi Children Hospital, Ancona, Italy
  3. 3Department of Information Engineering, University of Padova, Padova, Italy

Abstract

Background Animal studies show that the amount of exogenous surfactant does not affect surfactant half-life. No information is available in humans.

Objective To study surfactant disaturated phosphatidylcholine (DSPC) half-life in infants with respiratory distress syndrome (RDS), treated with 200 or 100 mg/kg exogenous surfactant.

Methods DSPC half-life was studied in 61 preterm infants with RDS, who needed mechanical ventilation and early rescue exogenous surfactant. Infants were treated with 200 (GR200, n  =  21) or 100 mg/kg (GR100, n  =  40) porcine surfactant at the discretion of the attending neonatologist. Clinical and respiratory parameters were recorded at study recruitment and then every 6 h. DSPC kinetics were calculated from the decay of DSPC 13C-enrichment from serial tracheal aspirates. Comparisons were made by t test and χ2 test.

Results Clinical characteristics were not different between groups. In GR200, only six infants (28.6%) received a second dose and one received three doses, whereas in GR100, 28 (70%) received a second dose and nine (22.5%) a third dose. Mortality, the incidence of bronchopulmonary dysplasia and duration of mechanical ventilation were not different. Infants in the GR200 group exhibited a greater and significant reduction in the oxygenation index compared with the GR100 group. DSPC half-life was 53 ± 23 h and 38 ± 19 h (p = 0.029) for the first dose and 75 ± 19 h and 50 ± 28 h (p = 0.025) for the second dose in GR200 and GR100, respectively.

Conclusion Doses of 200 mg/kg of porcine surfactant given to infants for RDS resulted in significantly longer DSPC half-life, reduced the need for re-treatment and better oxygenation indexes compared with doses of 100 mg/kg.

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