Background and Aims French and Finnish studies report a rise in C-reactive protein [CRP] after poractant alfa [PA] therapy; we have made a similar observation. Neither study excluded perinatal infection as a cause. This research hypothesized that the rise in CRP was not caused by infection but rather by a reaction to PA.

Methods This study reviewed newborns weighing < 1500 g at birth with respiratory distress syndrome [RDS] and who received PA. Clinical and radiographic criteria defined RDS. Clinical and laboratory findings established that infection was not present in the mother or infant (inclusion criteria). Infants given PA were compared to infants with RDS and no therapy [NO-PA]. A CRP measurement ≥1 mg/dL was considered elevated. SPSS was used for statistical analyses.

Results The 2^nd and 3^rd CRP rose in PA v. a decline in NO-PA [Table]. Tracheal aspirate and blood cultures had no growth in all subjects.

Conclusions CRP significantly increased in PA v. NO-PA supporting prior reports. We theorize inflammation is caused by peroxidation of polyunsaturated fatty acids in PA. A clinical trial is needed that studies cytologic and biochemical findings in tracheal aspirates after PA therapy and this will alleviate safety concerns.