Poractant alfa in respiratory distress syndrome in preterm infants: a profile of its use

Abstract

Poractant alfa (Curosurf®) is a natural, porcine-derived surfactant that is well established as an effective and generally well-tolerated agent in the treatment of respiratory distress syndrome (RDS) in preterm infants. The efficacy of poractant alfa in RDS is better than that of early-generation synthetic surfactants, and limited data are available regarding its efficacy versus new-generation synthetic agents. Poractant alfa 200 mg/kg is more effective than poractant alfa 100 mg/kg or bovine-derived beractant 100 mg/kg. Techniques for administering poractant alfa include via an endotracheal tube or less invasive techniques [e.g. less invasive surfactant administration (LISA)] performed during non-invasive ventilation of spontaneously breathing infants via nasal continuous positive airway pressure (CPAP). Administration of poractant alfa 200 mg/kg in early rescue [i.e. fraction of inspired oxygen (FiO2) ≥ 0.3] via LISA is associated with increased successful management on continuous positive airway pressure, as well as reductions in the incidence of bronchopulmonary dysplasia (BPD) and death/BPD.