Curosurf for therapy in neonatal RDS: an Italian randomized clinical trial

Abstract

Since 1984 a European multicentre trial (EMCT) on the use of a natural surfactant extracted from minced porcine lungs (Curosurf) in the treatment of neonatal RDS has been in progress. In the first phase of the study, finished in 1987, the effectiveness of a single dose of Curosurf (200 mg kg⁻¹) in improving clinical conditions and short-term outcome of newborn infants suffering from severe RDS (on intermittent positive pressure ventilation (IPPV) with F_iO₂≥0.6) was demonstrated [1]. The most obvious and immediate effect was observed on alveolar gas exchange, as documented by a rapid and marked increase in the value of P_aO₂/F_iO₂ ratio, which was significantly higher in treated versus control infants just 5 min after surfactant administration. This difference remained until 48 h after randomization. Besides mortality, frequency of pulmonary interstitial emphysema (PIE) and pneumothorax (PTX) was significantly lower in the treated infants than in the control babies. Duration of mechanical ventilation and frequency of bronchopulmonary dysplasia (BPD) was lower in the treated newborns, too, though the difference was not significant [1].