Comparing the Efficacy of two Natural Surfactants, Curosurf and Alveofact, in Treatment of Respiratory Distress Syndrome in Preterm Infants

Surfactant replacement therapy and respiratory support are the corn stones for respiratory distress syndrome treatment. Natural surfactants, which are animal derived, have been considered superior to synthetic ones, but the superior type of natural surfactant is still unknown. This study was conducted to compare the efficacy of two types of natural surfactants, Poractan alfa (Curosurf) and Alveofact, in the treatment of respiratory distress syndrome (RDS). In a randomized clinical trial 130 inborn preterm newborn infants with gestation age less than 32 weeks were randomly allocated to two groups; 66 neonates received Curosurf and 64 infants treated with Alveofact. Demographic characteristics of infants were similar in two groups’ patients. The mean number of surfactant replacement therapy was significantly more in Alveofact group (1.79 ±0.92 vs. 1.22±0.48, p<0.001). The remaining on ventilator support through 7 days was noted in 9 infants that all of them was treated with Alveofact, p=0.001. The mean duration of oxygen supplementation and hospital stay were 10.97±2.21 and 24.50±23.85 days in Alveofact group vs. 7.31±1.65 and 25.25±20.61days in Curosurf group, p=0.03 and p=0.16 respectively. The rate of complications was similar among patients in two groups. Our data demonstrate short term benefit with respect to respiratory support in Curosurf treated patients without significant difference in other consequences till discharge. Future studies with larger number of patients are recommended for determining superior natural surfactant.