Comparison of treatment regimens of natural surfactant preparations in neonatal respiratory distress syndrome

Excerpt

Sir: The study by Baroutis and coworkers contains several important inaccuracies, the sum of which combine to cast doubt on the validity of their results and conclusions [1]. The fundamental methodological flaw in the design of this study is that one of the study drugs evaluated, Survanta (beractant), was administered slowly by pump via a side port adaptor to the endotracheal tube. The authors state that this is the method recommended in the Survanta package insert, which is not the case. This method of administration is not an approved method. The Survanta package insert, which is consistent for all countries in which the drug is approved, recommends that Survanta be administered distally in aliquots using bolus dosing through an end-hole catheter [3]. This method assures that the drug directly reaches its site of action in the lung. Administration of Survanta by any other method than that recommended in the package insert, including the method used by Baroutis et al. [1], should in fact be avoided as it may produce uneven distribution of the drug in the lung. It is of interest that the authors themselves state this in their discussion section. …