Abstract
The benefits of exogenous synthetic or animal-derived surfactants for prevention or treatment of respiratory distress syndrome (RDS) are well established. Data from head-to-head trials comparing animal-derived surfactants primarily with the synthetic surfactant colfosceril suggest that the major clinical advantages afforded by the presence of surfactant protein (SP)-B and SP-C in animal-derived preparations relate to faster onset of action, a reduction in the incidence of RDS when used prophylactically, and a lower incidence of air leaks and RDS-related deaths. However, no benefits in terms of overall mortality or BPD have been shown in these head-to-head comparisons. Findings from trials of a new-generation synthetic surfactant containing a peptide that mimics SP-B, as well as their follow-up study suggest that its administration improves short-term clinical outcomes compared with colfosceril and results in survival through 1 year of age, which is at least comparable, if not perhaps superior, to that seen with animal-derived surfactants.
MeSH terms
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Animals
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Biological Products / administration & dosage
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Biological Products / adverse effects
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Biological Products / chemical synthesis
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Bronchopulmonary Dysplasia / drug therapy
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Bronchopulmonary Dysplasia / mortality
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Dose-Response Relationship, Drug
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Drug Combinations
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Evidence-Based Medicine*
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Fatty Alcohols / administration & dosage
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Fatty Alcohols / adverse effects
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Fatty Alcohols / chemical synthesis
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Follow-Up Studies
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Humans
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Infant, Newborn
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Intensive Care, Neonatal
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Phosphatidylglycerols / administration & dosage
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Phosphatidylglycerols / adverse effects
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Phosphatidylglycerols / chemical synthesis
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Phospholipids / administration & dosage
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Phospholipids / adverse effects
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Phospholipids / chemical synthesis
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Phosphorylcholine / administration & dosage
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Phosphorylcholine / adverse effects
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Phosphorylcholine / chemical synthesis
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Polyethylene Glycols / administration & dosage
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Polyethylene Glycols / adverse effects
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Polyethylene Glycols / chemical synthesis
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Proteins / administration & dosage
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Proteins / adverse effects
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Proteins / chemical synthesis
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Pulmonary Surfactant-Associated Proteins / administration & dosage
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Pulmonary Surfactant-Associated Proteins / adverse effects
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Pulmonary Surfactant-Associated Proteins / analysis
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Pulmonary Surfactants / administration & dosage
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Pulmonary Surfactants / adverse effects
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Pulmonary Surfactants / chemical synthesis*
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Randomized Controlled Trials as Topic*
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Respiratory Distress Syndrome, Newborn / drug therapy*
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Respiratory Distress Syndrome, Newborn / mortality
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Survival Rate
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Treatment Outcome
Substances
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Biological Products
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Drug Combinations
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Fatty Alcohols
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Phosphatidylglycerols
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Phospholipids
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Proteins
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Pulmonary Surfactant-Associated Proteins
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Pulmonary Surfactants
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lucinactant
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Phosphorylcholine
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Polyethylene Glycols
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dipalmitoylphosphatidylcholine, hexadecanol, tyloxapol drug combination
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poractant alfa
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calfactant
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beractant