Exogenous
surfactants have been used as an effective treatment of
neonatal respiratory distress syndrome (RDS). Different preparations of
surfactant carry different biophysical and clinical properties. To study the response pattern and treatment outcome of two natural
surfactants (bLES and
Survanta) for the treatment of RDS, we conducted a randomized clinical trial at the neonatal unit of a university teaching hospital. Premature babies with
birth weight between 500-1,800 g who developed RDS requiring
mechanical ventilation with an
oxygen requirement of more than 30% within 6 hr of life were randomized into two treatment groups. Oxygenation indices (OIs) within 12 hr of treatment were compared as primary outcomes, while neonatal complications were analyzed as secondary outcomes of the study. Sixty babies were recruited, with 29 in the bLES and 31 in the
Survanta treatment group. Both groups had significant and sustained improvements in OI after
surfactant replacement
therapy (SRT), while the bLES group was associated with a significantly lower OI throughout the initial 12 hr
after treatment compared with the
Survanta group. There was no difference in secondary outcomes including mortality,
ventilator days, and occurrence of chronic
lung disease. We conclude that infants with RDS respond favorably to both types of
surfactant replacement, and that bLES achieved a faster clinical response in terms of improvement in OI than
Survanta.