Ductal patency in neonates with respiratory distress syndrome. A randomized surfactant trial
M. D. Reller, D. C. Buffkin, M. A. Colasurdo, M. J. Rice and R. W. McDonald
Department of Pediatrics, Oregon Health Sciences University, Portland 97201-3042.
The purpose of this study was to evaluate in a controlled study the effect
of exogenous surfactant on various manifestations of ductal patency.
Premature infants with respiratory distress syndrome were randomized to
receive surfactant (Survanta) (n = 22) or air (n = 14). In neonates
receiving surfactant, there was a greater tendency for an audible murmur to
develop (13 of 22 vs four of 14). In spite of this, the clinical use of
indomethacin was similar for the two groups, 10 (45%) of 22 vs six (43%) of
14. Excluding neonates given indomethacin early, a comparable number of
surfactant-treated neonates (9/17 [53%]) vs control neonates (6/12 [50%])
demonstrated spontaneous closure of the ductus within a physiologic time
frame (on or before day 4). For the gestational ages studied, the
beneficial effects of exogenous surfactant were not associated with either
an increased risk for delayed closure of the ductus arteriosus or a greater
incidence of indomethacin usage. Utilization of exogenous surfactant does
not appear to have an adverse impact on ductal patency.
