Comparative effectiveness of calfactant and beractant in neonatal respiratory distress syndrome: A systemic review and meta-analysis.

ABSTRACT

INTRODUCTION: Animal derived surfactants are considered to be the standard treatment for neonatal respiratory distress syndrome (NRDS). However, their comparative effectiveness remains inconclusive given the multiple prior studies with inconsistent results. Therefore, we conducted a systematic review and meta analysis to compare the effectiveness of two animal extract surfactants (calfactant and beractant) for the management of NRDS. METHODS: We searched Pubmed, Scopus, and Google Scholar for studies comparing efficacy of calfactant and beractant for the treatment of NRDS. Mean differences (MD) and risk ratios (RR) with a 95% confidence interval (CI) were calculated using Review Manager. RESULT: We found no significant difference between calfactnat and beractant groups in the primary outcomes: neonatal mortality before the age of 28 days (RR = 1.19, 95% CI = 0.97-1.46, p = 0.09), mortality before the hospital release (RR = 1.12, 95% Cl = 0.94-1.33, p = 0.22), oxygen requirement at 28 days of age (RR = 0.97, 95% CI = 0.90-1.05, p = 0.52), and death or oxygen need at 36 weeks postmenstrual age (RR = 0.99, 95% CI = 0.91-1.08, p = 0.81). The duration of supplementary oxygen was significantly lower in calfactant users (MD = -4.95, 95% CI = -7.60--2.30, p = 0.0002). Calfactant significantly lowered the duration of hospital stay, risk of pneumothorax and air leak syndrome whereas beractant users had lower risk of intraventricular hemorrhage (Grades 3 and 4). CONCLUSION: There is no substantial difference in the efficacy of both surfactants in the prophylaxis and treatment of NRDS.