Preface - Ous-research.no

The effect of a synthetic surfactant CHF 5833 versus poractant alfa in a
newborn pig model of meconium aspiration syndrome
Department of Pediatric Research, Oslo University Hospital, Rikshospitalet
Investigators
Ola Didrik Saugstad, Professor, MD, PhD, (UiO/OUH)
Bodil Salvesen, MD, PhD, (OUH)
Poractant alfa is an animal derived surfactant important in the treatment of respiratory distress syndrome (RDS) in premature infants.
Surfactant therapy significantly reduces mortality and morbidity. Shortly after administration, the surfactant rapidly coats the alveoli
to stabilize against collapse. By reducing surface tension, it helps facilitate lung expansion and gas exchange in premature children.
Naturally derived surfactants are expensive to produce. The development of clinically active synthetic surfactants has been complicated
especially to synthesize the hydrophobic surfactant proteins SP-B and SP-C. Meconium displaces surfactant from the alveolar
surface and inhibits surfactant function. Bronchial lavage fluid from infants contains increased levels of albumin, total protein, and
membrane derived phospholipids which also may inhibit surfactant activity.
CHF5633 is a new syntethic surfactant designed to act similar to poractant alfa.
OBJECTIVE
The aim of the study was to compare the effect of poractant alfa versus CHF5633 in an experimental model of meconium aspiration
syndrome mainly focusing on surfactant inhibition.
EXPERIMENTAL SET UP
26 newborn pigs age 12 to 36 hours, weight 1.4 to 2 kg were randomized into two groups.
The pigs were anesthetized according to a well known model of MAS. Ten minutes after meconium was instilled endotracheally, either
poractant alfa or CHF5633 was instilled.
Bronchial lavage fluid was obtained every second hour to measure the phospholipid concentration reflecting surfactant activity.
Respiratory data were registered every hour. Blood was drawn every hour to investigate complement activation and cytokine formation.
RESULTS
Oxygenation index increased to 22 in the poractant alfa group versus 19 in the CHF5633 group.
Ventilation index increased to 85 in the poractant alfa group versus 84 in the CHF5633 group.
Bronchial lavage fluid will be analyzed in Stockholm.
The terminal complement complex reflecting complement activation and proinflammatory cytokines will be analyzed in Oslo.
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