Abstract
The postnatal growth, respiratory status and neurodevelopmental outcome of surviving babies enrolled in the first European multicentre trial of porcine surfactant (Curosurf) replacement for severe neonatal respiratory distress syndrome, were assessed at corrected ages of 1 and 2 years. Follow up rates of survivors were 93% at 1 year and 89% at 2 years. Treated and control groups were similar at both 1 and 2 years in terms of physical growth, the prevalence of persistent respiratory symptoms and the occurrence of major and minor disability. Serum antibodies recognising Curosurf and surfactant-anti-surfactant immune complexes were detected in both treated and control babies, the titres showing no difference between groups. Examination of histological lung sections from non-survivors revealed a higher incidence of severe pulmonary interstitial emphysema in control babies than in those treated with surfactant. Surfactant treatment for severe respiratory distress syndrome reduces neonatal mortality and air leaks and is not associated with an increase in disability 2 years later.
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Abbreviations
- DQ:
-
Griffiths developmental quotient
- OFC:
-
occipitofrontal head circumference
- RDS:
-
respiratory distress syndrome
References
Chida S, Phelps DS, Soll RF, Taeusch HW (1991) Surfactant proteins and anti-surfactant antibodies in sera from infants with respiratory distress syndrome with and without surfactant treatment. Pediatrics 88:84–89
Collaborative European Multicenter Study Group (1988) Surfactant replacement therapy for severe neonatal respiratory distress syndrome; an international randomized clinical trial. Pediatrics 82:683–691
Dunn MS, Shennan AT, Hoskins EM, Lennox K, Enhorning G (1988) Two year follow-up of infants enrolled in a randomized trial of surfactant therapy for prevention of neonatal respiratory distress syndrome. Pediatrics 82:543–547
Enhorning G, Shennan A, Possmayer F, Dunn M, Chen CP, Milligan J (1985) Prevention of neonatal respiratory distress syndrome by tracheal instillation of surfactant: a randomized clinical trial. Pediatrics 76:145–153
Fujiwara T, Maeta H, Chida S, Morita T, Watabe Y, Tadaaki A (1980) Artificial surfactant therapy in hyaline-membrane disease. Lancet I:55–59
Griffiths R (1954) The abilities of babies. University of London Press, London
Hagberg B, Hagberg G, Olow I (1975) The changing panorama of cerebral palsy in Sweden 1954–1970. II Analysis of the various syndromes. Acta Paediatr Scand 64:193–200
Hallman M, Merritt TA, Jarvenpaa AL, Boynton B, Mannino F, Gluck L, Moore T, Edwards D (1985) Exogenous human surfactant for treatment of severe respiratory distress syndrome: a randomized prospective clinical trial. J Pediatr 106:963–969
Halliday HL, McClure BG, Reid MMcC (1986) Growth and development two years after artificial surfactant replacement at birth. Early Hum Dev 3:323–327
Kwong MS, Egan EA, Notter RH, Shapiro DH (1985) Double blind clinical trial of calf lung surfactant extract for the prevention of hyaline membrane disease in extremely premature infants. Pediatrics 76:585–592
Morley CJ, Morley R (1990) Follow-up of premature babies treated with artificial surfactant (ALEC). Arch Dis Child 65: 667–669
Msall ME, Rodgers BT, Catanzaro N, Kwong M, Buck G (1989) Five year neurodevelopmental outcome of infants less than 28 weeks gestational age enrolled in a surfactant randomised clinical trial. Pediatr Res 25:258A
Noack G, Berggren P, Curstedt T, Grossmann G, Herin P, Mortensson W, Nilsson R, Robertson B (1987) Severe neonatal respiratory distress syndrome treated with the phospholipid fraction of natural surfactant. Acta Paediatr Scand 76: 697–705
Robertson B, Curstedt T, Johansson J, Jornvall H, Kobayashi T (1990) Structural and functional characteristics of porcine surfactant isolated by liquid gel chromatography. Prog Respir Res 25:237–246
Shapiro DL, Notter RH, Morin FC, Deluga KS, Golub LM, Sinkin RA, Weiss KI, Cox C (1985) Double-blind, randomized trial of calf lung surfactant extract administered at birth to very premature infants for the prevention of respiratory distress syndrome. Pediatrics 76:593–595
Strayer DS, Merritt TA, Hallman N (1989) Surfactant replacement: immunological considerations. Eur Respir J [Suppl] 2 (3):91S-96S
Strayer DS, Merritt TA, Lwebuga-Musaka J, Hallman M (1986) Surfactant-anti-surfactant immune complexes in infants with respiratory distress syndrome. Am J Pathol 122:353–362
Strayer DS, Merritt TA, Makunike C, Hallman M (1989) Antigenicity of low molecular weight surfactant species. Am J Pathol 134:723–732
Vaucher YE, Merritt TA, Hallman M, Jarvenpaa AL, Telsey AM, Jones BL (1988) Neurodevelopmental and respiratory outcome in early childhood after human surfactant treatment. Am J Dis Child 142:927–930
Ware J, Taeusch HW, Soll RF, McCormick MC (1990) Health and developmental outcomes of a surfactant controlled trial: follow-up at 2 years. Pediatrics 85:1103–1107
Whitsett JA, Hull WM, Luse S (1991) Failure to detect surfactant protein-specific antibodies in sera of premature infants treated with Survanta, a modified bovine surfactant. Pediatrics 87:505–510
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Collaborative European Multicentre Study Group:., Robertson, B., Curstedt, T. et al. A 2-year follow up of babies enrolled in a European multicentre trial of porcine surfactant replacement for severe neonatal respiratory distress syndrome. Eur J Pediatr 151, 372–376 (1992). https://doi.org/10.1007/BF02113261
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DOI: https://doi.org/10.1007/BF02113261