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

  • 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.


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.


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

MeSH Terms

Infant, Extremely Premature
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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