Download PDF
Am J Perinatol 2021; 38(06): 590-596
DOI: 10.1055/s-0039-1700856
Original Article

Evaluation of Different Types of Natural Surfactants by Lung Ultrasound in Respiratory Distress Syndrome

Davut Bozkaya
1   Division of Neonatology, Zekai Tahir Burak Women's Health Training and Research Hospital, University of Health Sciences, Ankara, Turkey
,
Evrim Alyamaç Dizdar
1   Division of Neonatology, Zekai Tahir Burak Women's Health Training and Research Hospital, University of Health Sciences, Ankara, Turkey
,
Sabriye Korkut
1   Division of Neonatology, Zekai Tahir Burak Women's Health Training and Research Hospital, University of Health Sciences, Ankara, Turkey
,
Burak Ceran
1   Division of Neonatology, Zekai Tahir Burak Women's Health Training and Research Hospital, University of Health Sciences, Ankara, Turkey
,
Mihriban Alkan
2   Division of Radiology, Zekai Tahir Burak Women's Health Training and Research Hospital, University of Health Sciences, Ankara, Turkey
,
Şerife Suna Oğuz
1   Division of Neonatology, Zekai Tahir Burak Women's Health Training and Research Hospital, University of Health Sciences, Ankara, Turkey
› Author Affiliations Funding None.
› Further Information
Also available at
    Permissions and Reprints

Abstract

Objective This study aimed to compare the lung ultrasonography (LUS) scores after two different natural surfactant administration as a parameter reflecting lung inflation.

Study Design Preterm infants of 32 gestational weeks and below who were diagnosed with respiratory distress syndrome (RDS) were randomly assigned to be administered either poractant alfa or beractant, prospectively. Serial LUS scans were obtained by an experienced neonatologist in a standardized manner before and after (2 and 6 hours) surfactant administration. The LUS scans were evaluated by protocols based on scores and lung profiles.

Results Thirty-seven infants received poractant alfa and 36 received beractant. The baseline characteristics and presurfactant LUS scores were similar in groups. The scores were significantly decreased after surfactant administration in both groups (2 hours, p = < 0.001; 6 hours, p = < 0.001). LUS scores in poractant group were significantly lower than beractant group when compared at each time point. At the end of 6 hours, the number of infants with the normal profile was significantly higher in the poractant group (∼65%) than the beractant group (22%).

Conclusion LUS is beneficial for evaluating lung aeration after surfactant treatment in preterm infants with RDS. A better lung aeration can be achieved in the early period with the use of poractant alfa.

Keywords

lung ultrasound - premature infants - respiratory distress syndrome - surfactant

Authors' Contributions

All authors designed, supervised, and analyzed the study, and prepared the manuscript. All authors read and approved the final manuscript.




Publication History

Received: 19 June 2019

Accepted: 23 September 2019

Article published online:
26 November 2019

© 2019. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Volpicelli G, Elbarbary M, Blaivas M. et al; International Liaison Committee on Lung Ultrasound (ILC-LUS) for International Consensus Conference on Lung Ultrasound (ICC-LUS). International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med 2012; 38 (04) 577-591
    CrossrefPubMedSearch in Google Scholar
  • 2 Lichtenstein DA, Mauriat P. Lung ultrasound in the critically ill neonate. Curr Pediatr Rev 2012; 8 (03) 217-223
    CrossrefPubMedSearch in Google Scholar
  • 3 Raimondi F MF, Sodano A, Vallone G. et al. Point-of-care chest ultrasound in the neonatal intensive care unit: an Italian perspective. J Pediatr 2014; 40 (02) A25
    PubMedSearch in Google Scholar
  • 4 Raimondi F, Yousef N, Migliaro F, Capasso L, De Luca D. Point-of-care lung ultrasound in neonatology: classification into descriptive and functional applications. Pediatr Res 2018. Doi: 10.1038/s41390-018-0114-9
  • 5 Migliaro F, Sodano A, Capasso L, Raimondi F. Lung ultrasound-guided emergency pneumothorax needle aspiration in a very preterm infant. BMJ Case Rep 2014; 2014: 2014
    CrossrefPubMedSearch in Google Scholar
  • 6 Piastra M, Yousef N, Brat R, Manzoni P, Mokhtari M, De Luca D. Lung ultrasound findings in meconium aspiration syndrome. Early Hum Dev 2014; 90 (02) (Suppl. 02) S41-S43
    CrossrefPubMedSearch in Google Scholar
  • 7 Corsini I, Parri N, Gozzini E. et al. Lung ultrasound for the differential diagnosis of respiratory distress in neonates. Neonatology 2019; 115 (01) 77-84
    CrossrefPubMedSearch in Google Scholar
  • 8 Raschetti R, Yousef N, Vigo G. et al. Echography-guided surfactant therapy to improve timeliness of surfactant replacement: a quality improvement project. J Pediatr 2019; 212: 137-143
    CrossrefPubMedSearch in Google Scholar
  • 9 Copetti R, Cattarossi L, Macagno F, Violino M, Furlan R. Lung ultrasound in respiratory distress syndrome: a useful tool for early diagnosis. Neonatology 2008; 94 (01) 52-59
    CrossrefPubMedSearch in Google Scholar
  • 10 Brat R, Yousef N, Klifa R, Reynaud S, Shankar Aguilera S, De Luca D. Lung ultrasonography score to evaluate oxygenation and surfactant need in neonates treated with continuous positive airway pressure. JAMA Pediatr 2015; 169 (08) e151797
    CrossrefPubMedSearch in Google Scholar
  • 11 Raimondi F, Migliaro F, Sodano A. et al. Can neonatal lung ultrasound monitor fluid clearance and predict the need of respiratory support?. Crit Care 2012; 16 (06) R220
    CrossrefPubMedSearch in Google Scholar
  • 12 Raimondi F, Yousef N, Rodriguez Fanjul J. et al. A multicenter lung ultrasound study on transient tachypnea of the neonate. Neonatology 2019; 115 (03) 263-268
    CrossrefPubMedSearch in Google Scholar
  • 13 Dizdar EA, Sari FN, Aydemir C. et al. A randomized, controlled trial of poractant alfa versus beractant in the treatment of preterm infants with respiratory distress syndrome. Am J Perinatol 2012; 29 (02) 95-100
    Thieme ConnectPubMedSearch in Google Scholar
  • 14 Singh N, Hawley KL, Viswanathan K. Efficacy of porcine versus bovine surfactants for preterm newborns with respiratory distress syndrome: systematic review and meta-analysis. Pediatrics 2011; 128 (06) e1588-e1595
    CrossrefPubMedSearch in Google Scholar
  • 15 Fujii AM, Patel SM, Allen R, Doros G, Guo CY, Testa S. Poractant alfa and beractant treatment of very premature infants with respiratory distress syndrome. J Perinatol 2010; 30 (10) 665-670
    CrossrefPubMedSearch in Google Scholar
  • 16 Ramanathan R, Rasmussen MR, Gerstmann DR, Finer N, Sekar K. ; North American Study Group. A randomized, multicenter masked comparison trial of poractant alfa (Curosurf) versus beractant (Survanta) in the treatment of respiratory distress syndrome in preterm infants. Am J Perinatol 2004; 21 (03) 109-119
    Thieme ConnectPubMedSearch in Google Scholar
  • 17 Eras Z, Dizdar EA, Kanmaz G. et al. Neurodevelopmental outcomes of very low birth weight preterm infants treated with poractant alfa versus beractant for respiratory distress syndrome. Am J Perinatol 2014; 31 (06) 463-468
    PubMedSearch in Google Scholar
  • 18 Paul S, Rao S, Kohan R. et al. Poractant alfa versus beractant for respiratory distress syndrome in preterm infants: a retrospective cohort study. J Paediatr Child Health 2013; 49 (10) 839-844
    CrossrefPubMedSearch in Google Scholar
  • 19 Sweet DG, Carnielli V, Greisen G. et al. European consensus guidelines on the management of respiratory distress syndrome - 2016 update. Neonatology 2017; 111 (02) 107-125
    CrossrefPubMedSearch in Google Scholar
  • 20 Tita AT, Andrews WW. Diagnosis and management of clinical chorioamnionitis. Clin Perinatol 2010; 37 (02) 339-354
    CrossrefPubMedSearch in Google Scholar
  • 21 Zaichkin JG. Neonatal resuscitation: Neonatal Resuscitation Program 7th Edition Practice Integration. Crit Care Nurs Clin North Am 2018; 30 (04) 533-547
    CrossrefPubMedSearch in Google Scholar
  • 22 Zhou Y, Fan Q, Cavus O, Zhang X. Lung ultrasound: predictor of acute respiratory distress syndrome in intensive care unit patients. Saudi J Anaesth 2018; 12 (03) 457-461
    CrossrefPubMedSearch in Google Scholar
  • 23 Copetti R, Soldati G, Copetti P. Chest sonography: a useful tool to differentiate acute cardiogenic pulmonary edema from acute respiratory distress syndrome. Cardiovasc Ultrasound 2008; 6: 16
    CrossrefPubMedSearch in Google Scholar
  • 24 Bahadue FL, Soll R. Early versus delayed selective surfactant treatment for neonatal respiratory distress syndrome. Cochrane Database Syst Rev 2012; 11: CD001456
    Search in Google Scholar
  • 25 Gargani L, Lionetti V, Di Cristofano C, Bevilacqua G, Recchia FA, Picano E. Early detection of acute lung injury uncoupled to hypoxemia in pigs using ultrasound lung comets. Crit Care Med 2007; 35 (12) 2769-2774
    PubMedSearch in Google Scholar
  • 26 Lovrenski J, Sorantin E, Stojanović S, Doronjski A, Lovrenski A. Evaluation of surfactant replacement therapy effects--a new potential role of lung ultrasound. Srp Arh Celok Lek 2015; 143 (11-12): 669-675
    CrossrefPubMedSearch in Google Scholar
  • 27 Cattarossi L, Copetti R, Poskurica B, Miserocchi G. Surfactant administration for neonatal respiratory distress does not improve lung interstitial fluid clearance: echographic and experimental evidence. J Perinat Med 2010; 38 (05) 557-563
    CrossrefPubMedSearch in Google Scholar
  • 28 De Martino L, Yousef N, Ben-Ammar R, Raimondi F, Shankar-Aguilera S, De Luca D. Lung ultrasound score predicts surfactant need in extremely preterm neonates. Pediatrics 2018; 142 (03) e20180463
    CrossrefPubMedSearch in Google Scholar
  • 29 Tridente A, De Martino L, De Luca D. Porcine vs bovine surfactant therapy for preterm neonates with RDS: systematic review with biological plausibility and pragmatic meta-analysis of respiratory outcomes. Respir Res 2019; 20 (01) 28
    CrossrefPubMedSearch in Google Scholar
  • 30 Abdelmawla M, Louis D, Narvey M, Elsayed Y. A lung ultrasound severity score predicts chronic lung disease in preterm infants. Am J Perinatol 2019;
    Thieme ConnectPubMedSearch in Google Scholar
  • 31 Ardell S, Pfister RH, Soll R. Animal derived surfactant extract versus protein free synthetic surfactant for the prevention and treatment of respiratory distress syndrome. Cochrane Database Syst Rev 2015; (05) CD000144
    PubMedSearch in Google Scholar