A pig-derived surfactant given to premature babies whose lungs aren't yet making the lubricant reduces mortality rates by 19 percent over two other commercially-available surfactants, researchers say.
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.