Respiratory outcomes following 100 mg/kg v. 200 mg/kg of poractant alpha: A retrospective review

Abstract

Background. e treatment guideline for the management of respiratory distress syndrome in the newborn unit at Auckland City Hospital (ACH), Auckland, New Zealand, was amended in July 2010. In keeping with current evidence, the initial dose of poractant alpha was increased from 100 mg/kg to 200 mg/kg. e outcomes of newborns requiring treatment with surfactant before and aer this change were reviewed.
Methods. Electronic clinical records were reviewed of infants admitted to ACH who received surfactant during the period December 2008 - December 2011. ere were two groups: group A were infants who received 100 mg/kg of poractant alpha as an initial dose (December 2008 - June 2010), and group B were infants who received 200 mg/kg as an initial dose (July 2010 - December 2011). Infants with congenital anomalies and those treated with surfactant before transfer to ACH were excluded.
Results. A total of 256 infants were included in the analysis, 118 in group A and 138 in group B. Infants in group B had a higher median gestational age (28 v. 27 weeks; p=0.52) and birth weight (1 065 g v. 930 g; p=0.08) compared with infants in group A. Signicantly more infants in group A received more than one dose of surfactant (33.9% v.15.9%; odds ratio 2.7; p=0.0008). Infants in group B showed a signicant reduction in oxygen requirement aer the administration of surfactant (p=0.0003).
Conclusion. e administration of 200 mg/kg poractant alpha led to a signicant improvement in oxygenation and a reduction in the need for further doses of surfactant.