J Korean Med Sci.  2014 Aug;29(8):1126-1131. 10.3346/jkms.2014.29.8.1126.

Early Prophylactic versus Late Selective Use of Surfactant for Respiratory Distress Syndrome in Very Preterm Infants: A Collaborative Study of 53 Multi-Center Trials in Korea

Affiliations
  • 1Department of Pediatrics, Busan St. Mary's Medical Center, Busan, Korea.
  • 2Department of Pediatrics, Kyung Hee University School of Medicine, Seoul, Korea. baecw@khnmc.or.kr
  • 3Department of Preventive Medicine, Pusan National University School of Medicine, Busan, Korea.

Abstract

Pulmonary surfactant (PS) therapy was proven to be highly successful for the treatment of respiratory distress syndrome in premature infants. As a results, early prophylactic (EP) PS therapy has been introduced recently in Europe, the US and Korea. However, no multi-center study was compared EP and late selective (LS) PS therapies in Korea. We performed a retrospective multi-center study to compare the outcomes of EP and LS PS therapies in very preterm infants. We analyzed clinical morbidity and mortality for 1,291 infants in 2010 (LS group) and 1,249 infants in 2011 (EP group); the infants were born <30 weeks of gestation and had birth weight < or =1,250 g, and were chosen from 53 neonatal intensive care units in Korea. Compared to the LS group (22.5%), the overall mortality was better in the EP group (19.9%) and there was no increased need for retreatment.There were additional benefits in the EP group such as fewer associated complications. To the best of knowledge, our study is the first nationwide Korean study to compare the outcomes of EP and LS therapies, and it provides evidences that EP PS therapy is important in very preterm infants to improve for survival and reduce morbidities.

Keyword

Surfactant; Effectiveness; Treatment; Treatment Outcome; Infant; Preterm; Respiratory Distress Syndrome, Newborn

MeSH Terms

Female
Humans
Infant, Extremely Premature
Male
Prevalence
Pulmonary Surfactants/*administration & dosage
Republic of Korea/epidemiology
Respiratory Distress Syndrome, Newborn/diagnosis/*mortality/*prevention & control
Risk Factors
Secondary Prevention/methods/*statistics & numerical data
Survival Rate
Treatment Outcome
Pulmonary Surfactants

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Reference

1. Fujiwara T, Maeta H, Chida S, Morita T, Watabe Y, Abe T. Artificial surfactant therapy in hyaline-membrane disease. Lancet. 1980; 1:55–59.
2. Halliday HL. Surfactants: past, present and future. J Perinatol. 2008; 28:Suppl 1. S47–S56.
3. Bae CW, Kwon YD, Ko SJ, Kim KS, Kim HM, Park WS, Byun SH, Son CS, Ahn HS, Lee SG, et al. Surfactant replacement therapy in neonates with respiratory distress syndrome: a collective evaluation of trials from 16 hospitals. J Korean Pediatr Soc. 1993; 36:244–265.
4. Bae CW. Surfactant replacement therapy in RDS: a collaborative study of multi-center trials in Korea. J Korean Soc Neonatol. 1997; 4:124–135.
5. Bae CW, Kim YM. Surfactant therapy for neonatal respiratory distress syndrome: experience in Korea over 15 years. Korean J Pediatr. 2004; 47:940–948.
6. Bae CW, Hahn WH. Surfactant therapy for neonatal respiratory distress syndrome: a review of Korean experiences over 17 years. J Korean Med Sci. 2009; 24:1110–1118.
7. Bae CW, Hahn WH, Chang JY, Kim SM. Surfactant replacement therapy for RDS: a collaborative study of 72 multi-center trials in Korea (2010) and a review of Korean experiences over 20 years. J Korean Soc Neonatol. 2011; 18:409–411.
8. Sweet DG, Carnielli V, Greisen G, Hallman M, Ozek E, Plavka R, Saugstad OD, Simeoni U, Speer CP, Halliday HL, et al. European consensus guidelines on the management of neonatal respiratory distress syndrome in preterm infants - 2010 update. Neonatology. 2010; 97:402–417.
9. Engle WA. American Academy of Pediatrics Committee on Fetus and Newborn. Surfactant-replacement therapy for respiratory distress in the preterm and term neonate. Pediatrics. 2008; 121:419–432.
10. Kirsten GF, Kirsten CL, Henning PA, Smith J, Holgate SL, Bekker A, Kali GT, Harvey J. The outcome of ELBW infants treated with NCPAP and InSurE in a resource-limited institution. Pediatrics. 2012; 129:e952–e959.
11. Stevens TP, Harrington EW, Blennow M, Soll RF. Early surfactant administration with brief ventilation vs. selective surfactant and continued mechanical ventilation for preterm infants with or at risk for respiratory distress syndrome. Cochrane Database Syst Rev. 2007; (4):CD003063.
12. Jobe AH. Pulmonary surfactant therapy. N Engl J Med. 1993; 328:861–868.
13. Pramanik AK, Holtzman RB, Merritt TA. Surfactant replacement therapy for pulmonary diseases. Pediatr Clin North Am. 1993; 40:913–936.
14. Soll RF, Morley CJ. Prophylactic versus selective use of surfactant in preventing morbidity and mortality in preterm infants. Cochrane Database Syst Rev. 2001; (2):CD000510.
15. Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr. 1978; 92:529–534.
16. Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med. 2001; 163:1723–1729.
17. Bell RS. Neonatal necrotizing enterocolitis. N Engl J Med. 1970; 283:153–154.
18. Sweet D, Bevilacqua G, Carnielli V, Greisen G, Plavka R, Saugstad OD, Simeoni U, Speer CP, Valls-I-Soler A, Halliday H, et al. European consensus guidelines on the management of neonatal respiratory distress syndrome. J Perinat Med. 2007; 35:175–186.
19. Sweet DG, Carnielli V, Greisen G, Hallman M, Ozek E, Plavka R, Saugstad OD, Simeoni U, Speer CP, Vento M, et al. European consensus guidelines on the management of neonatal respiratory distress syndrome in preterm infants: 2013 update. Neonatology. 2013; 103:353–368.
20. Kim SM, Yoon HS, Kim KS, Bae CW. The importance and the need of early pulmonary surfactant therapy in premature infant with respiratory distress syndrome. J Korean Soc Neonatol. 2009; 16:101–109.
21. Egberts J, de Winter JP, Sedin G, de Kleine MJ, Broberger U, van Bel F, Curstedt T, Robertson B. Comparison of prophylaxis and rescue treatment with Curosurf in neonates less than 30 weeks' gestation: a randomized trial. Pediatrics. 1993; 92:768–774.
22. Walti H, Paris-Llado J, Egberts J, Brand R, Bevilacqua G, Gardini F, Bréart G. Prophylactic administration of porcine-derived lung surfactant is a significant factor in reducing the odds for peri-intraventricular haemorrhage in premature infants. Biol Neonate. 2002; 81:182–187.
23. Tan KL. High frequency oscillatory ventilation in neonates with respiratory distress. Ann Acad Med Singapore. 1991; 20:219–222.
24. Rojas MA, Lozano JM, Rojas MX, Laughon M, Bose CL, Rondon MA, Charry L, Bastidas JA, Perez LA, Rojas C, et al. Very early surfactant without mandatory ventilation in premature infants treated with early continuous positive airway pressure: a randomized, controlled trial. Pediatrics. 2009; 123:137–142.
25. Kattwinkel J, Bloom BT, Delmore P, Davis CL, Farrell E, Friss H, Jung AL, King K, Mueller D. Prophylactic administration of calf lung surfactant extract is more effective than early treatment of respiratory distress syndrome in neonates of 29 through 32 weeks' gestation. Pediatrics. 1993; 92:90–98.
26. SUPPORT Study Group of the Eunice Kennedy Shriver NICHD Neonatal Research Network. Finer NN, Carlo WA, Walsh MC, Rich W, Gantz MG, Laptook AR, Yoder BA, Faix RG, Das A, Poole WK, et al. Early CPAP versus surfactant in extremely preterm infants. N Engl J Med. 2010; 362:1970.
27. Dunn MS, Kaempf J, de Klerk A, de Klerk R, Reilly M, Howard D, Ferrelli K, O'Conor J, Soll RF. Vermont Oxford Network DRM Study Group. Randomized trial comparing 3 approaches to the initial respiratory management of preterm neonates. Pediatrics. 2011; 128:e1069–e1076.
28. Rojas-Reyes MX, Morley CJ, Soll R. Prophylactic versus selective use of surfactant in preventing morbidity and mortality in preterm infants. Cochrane Database Syst Rev. 2012; 3:CD000510.
29. Hahn WH, Chang JY, Chang YS, Shim KS, Bae CW. Recent trends in neonatal mortality in very low birth weight Korean infants: in comparison with Japan and the USA. J Korean Med Sci. 2011; 26:467–473.
30. Chang JY, Lee KS, Hahn WH, Chung SH, Choi YS, Shim KS, Bae CW. Decreasing trends of neonatal and infant mortality rates in Korea: compared with Japan, USA, and OECD nations. J Korean Med Sci. 2011; 26:1115–1123.
31. Chung SH, Choi YS, Bae CW. Changes in neonatal epidemiology during the last 3 decades in Korea. Neonatal Med. 2013; 20:249–257.
32. Cho JH, Choi SK, Chung SH, Choi YS, Bae CW. Changes in neonatal and perinatal vital statistics during last 5 decades in Republic of Korea: compared with OECD nations. Neonatal Med. 2013; 20:402–412.
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