PROPHYLAXIS AND TREATMENT OF RESPIRATORY DISTRESS SYNDROME WITH DIFFERENT SURFACTANT PREPARATIONS

Abstract
Background. Treatment of RDS with exogenous surfactant has been shown very effective. However, is not clear if all surfactant preparations have the same efficacy.Aim. To evaluate if a particular surfactant preparation can be considered more effective than others in the prophylaxis and treatment of the RDS.Methods. A systematic bibliographic search has been performed in several databases to identify studies comparing any of these tensoactive preparations.Results. There is evidence that natural surfactants are more rapidly effective than the synthetic ones, and they might have lower complication and mortality rates. The porcine-derived surfactant might have some advantages over the bovine-derived beractant, with a faster action and a more favorable Pa/PAO₂ ratio in the first 24 h of therapy. There is also a trend toward a lower mortality rate (3%) among those treated with porcine in comparison to those treated with bovine-derived surfactant (12.5%).Conclusion. Clinical use of the commercialised synthetic surfactants is not supported by evidence. There is no scientific reason to support its use nowadays. The porcine derived surfactant might be considered as the first therapeutic choice, although it should be useful to have more additional studies to confirm this fact.

Key words
Exogenous surfactant, respiratory distress syndrome.

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