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Pilot trial of late booster doses of surfactant for ventilated premature infants

Journal of Perinatology volume 31, pages 599–606 (2011)Cite this article

Subjects

Abstract

Objective:

Many premature infants at risk for bronchopulmonary dysplasia experience episodes of surfactant dysfunction with reduced surfactant protein B (SP-B). In this study, we investigated the safety and responses to booster doses of surfactant.

Study Design:

A total of 87 infants, 500 to 1250 g birth weight, who were ventilated at 7 to 10 days received 2 or 3 doses of Infasurf (Calfactant, Forest Pharmaceuticals, St Louis, MO, USA) within a 1-week period.

Result:

For 184 doses, occurrence rates of transient bradycardia (13) and plugged endotracheal tube (5) were low, and no other adverse effects were noted. Treatment transiently improved the respiratory severity score (FiO2 × mean airway pressure), SP-B content (+75%) and surface properties of isolated surfactant. Levels of eight proinflammatory cytokines in tracheal aspirate were interrelated and unchanged from baseline after surfactant treatment.

Conclusion:

Booster doses of surfactant for premature infants with lung disease are safe and transiently improve respiratory status as well as composition and function of endogenous surfactant.

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Acknowledgements

We thank the NICU physicians, nurses and respiratory therapists at the following participating institutions for their cooperation in the trial: Hospital of the University of Pennsylvania and Children's Hospital of Philadelphia, Philadelphia, PA; North Shore-Long Island Jewish Health System, Long Island, NY; Children's Hospital and Research Center Oakland, Oakland, CA; Alta Bates Summit Medical Center, Berkeley, CA; St Louis Children's Hospital, St Louis, MO; Women and Children's Hospital of Buffalo, Buffalo, NY; Children's Memorial and Northwestern Memorial Hospitals, Chicago, IL; and Children's Mercy Hospital and Clinics, Kansas City, MO. We also thank Edmund Egan and William Taeusch for advice and support, and Marie Godinez, Yue Ning and Cheryl Chapin for technical assistance. Infasurf was kindly provided by Forest Laboratories. This research was supported by NIH K23-HL083091 and 5R01HL066410 (KWL), R01-HL65385 (AH), P50-HL56401 (PLB), M01-RR00240 GCRC Research Center (JM, PLB and RAB) and an unrestricted research grant from ONY (RAB).

Author information

Authors and Affiliations

  1. Department of Pediatrics, Children's Hospital and Research Center Oakland, Oakland, CA, USA

    J D Merrill & D J Durand

  2. Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA

    P L Ballard, K W Lu & R A Ballard

  3. Department of Pediatrics, Stony Brook University Medical Center, Stony Brook, NY, USA

    S E Courtney

  4. Department of Pediatrics, Washington University, St Louis, MO, USA

    A Hamvas

  5. Department of Pediatrics, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, OH, USA

    A M Hibbs

  6. Department of Pediatrics, Children's Hospital Buffalo, Buffalo, NY, USA

    R M Ryan & A M Reynolds

  7. Department of Pediatrics, St Louis University School of Medicine, St Louis, MO, USA

    K Spence

  8. Department of Pediatrics, Northwestern Memorial Hospital and Children's Memorial Hospital, Chicago, IL, USA

    R H Steinhorn

  9. Department of Pediatrics, Children's Mercy Hospitals and Clinics/University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA

    W E Truog

  10. Department of Pediatrics, University of Texas Health Science Center Houston, Houston, TX, USA

    E C Eichenwald

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  1. J D Merrill
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  14. R A Ballard
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Correspondence to J D Merrill.

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Merrill, J., Ballard, P., Courtney, S. et al. Pilot trial of late booster doses of surfactant for ventilated premature infants. J Perinatol 31, 599–606 (2011). https://doi.org/10.1038/jp.2010.210

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