Poractant alfa versus bovine lipid extract surfactant: prospective comparative effectiveness study

J Perinatol. 2022 Apr;42(4):468-475. doi: 10.1038/s41372-022-01346-0. Epub 2022 Feb 18.


Objective: To compare short term respiratory outcomes in preterm infants treated with bovine lipid extract surfactant or poractant alfa.

Study design: Prospective comparative effectiveness cohort study of infants <32 weeks' gestational age requiring surfactant in thirteen centers. Each center provided bovine lipid extract surfactant for a set period of time in the year 2019 and then changed to poractant alfa for the remainder of the year. The primary outcome was total duration of respiratory support.

Result: 968 infants were included. 494 received bovine lipid extract surfactant and 474 received poractant alfa. No difference was observed in the total duration of respiratory support (mechanical ventilation or non-invasive) (median 38 vs 40.5 days), need to re-dose surfactant, bronchopulmonary dysplasia, survival to discharge, or length of admission.

Conclusion: In this pragmatic study, we did not identify any difference in short term outcomes between the groups based on the type of surfactant received.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Biological Products* / therapeutic use
  • Cattle
  • Cohort Studies
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Phospholipids / therapeutic use
  • Prospective Studies
  • Pulmonary Surfactants* / therapeutic use
  • Respiratory Distress Syndrome, Newborn* / drug therapy
  • Surface-Active Agents / therapeutic use


  • Biological Products
  • Phospholipids
  • Pulmonary Surfactants
  • Surface-Active Agents
  • poractant alfa

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