Pilot trial of late booster doses of surfactant for ventilated premature infants.

Abstract

OBJECTIVE:

Many premature infants at risk for bronchopulmonary dysplasia experience episodes of surfactant dysfunction with reduced surfactant protein B (SP-B). In this study, we investigated the safety and responses to booster doses of surfactant.

STUDY DESIGN:

A total of 87 infants, 500 to 1250 g birth weight, who were ventilated at 7 to 10 days received 2 or 3 doses of Infasurf (Calfactant, Forest Pharmaceuticals, St Louis, MO, USA) within a 1-week period.

RESULT:

For 184 doses, occurrence rates of transient bradycardia (13) and plugged endotracheal tube (5) were low, and no other adverse effects were noted. Treatment transiently improved the respiratory severity score (FiO(2) × mean airway pressure), SP-B content (+75%) and surface properties of isolated surfactant. Levels of eight proinflammatory cytokines in tracheal aspirate were interrelated and unchanged from baseline after surfactant treatment.

CONCLUSION:

Booster doses of surfactant for premature infants with lung disease are safe and transiently improve respiratory status as well as composition and function of endogenous surfactant.

• Authors: J D Merrill, P L Ballard, S E Courtney, D J Durand, A Hamvas, A M Hibbs, K W Lu, R M Ryan, A M Reynolds, K Spence, R H Steinhorn, W E Truog, E C Eichenwald, R A Ballard
• Journal: Journal of perinatology : official journal of the California Perinatal Association (J Perinatol) Vol. 31 Issue 9 Pg. 599-606 (Sep 2011) ISSN: 1476-5543 [Electronic] United States
• PMID: 21311500 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Pulmonary Surfactants

Topics

• Bronchopulmonary Dysplasia (drug therapy, therapy)
• Female
• Humans
• Infant, Newborn
• Infant, Premature
• Male
• Pilot Projects
• Pulmonary Surfactants (administration & dosage)
• Respiration, Artificial
• Treatment Outcome