Effect of surfactant dose on outcomes in preterm infants with respiratory distress syndrome: the OPTI-SURF study

Related Experiment Video

Updated: Nov 26, 2025

Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome ARDS
06:22

Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome ARDS

Published on: April 7, 2021

3.7K

Kevin Colin William Goss1, Chris Gale2, Rachel Malone3

  • 1Neonatal Intensive Care Unit, University Hospital Southampton NHS Foundation Trust, Southampton, Hampshire, UK kevingoss@nhs.net.

BMJ Open
|December 14, 2020
PubMed

Insights

This study compares low versus high initial doses of surfactant for preterm infants with respiratory distress syndrome. The research aims to determine if lower doses improve survival without mechanical ventilation.

Area of Science:

  • Neonatal Medicine
  • Pediatric Respiratory Care
  • Clinical Pharmacology

Background:

  • Respiratory distress syndrome (RDS) is common in preterm infants due to surfactant deficiency.
  • European guidelines exist for surfactant administration, but clinical practice varies.
  • A 'whole vial' dosing approach is frequently used, deviating from recommended doses.

Purpose of the Study:

  • To evaluate the impact of a low initial surfactant dose (100-130 mg/kg) versus a high initial dose (170-200 mg/kg) in preterm infants (≤36 weeks+6 days).
  • To assess the effect on survival without mechanical ventilation on postnatal days 3 and 4.
  • To investigate other relevant neonatal outcomes associated with different surfactant dosing strategies.

Main Methods:

  • Prospective, observational study design.
  • Utilizing the National Neonatal Research Database for primary data.
  • Supplementing data with neonatal electronic patient record (EPR) system for surfactant administration details.
  • Employing propensity score matching to create comparable groups for low and high dose comparisons.

Main Results:

  • Pre-results phase; data collection and analysis are ongoing.
  • The study will provide insights into the efficacy of different surfactant dosing regimens.
  • Outcomes will be analyzed to determine clinical significance and potential practice changes.

Conclusions:

  • Findings will inform clinical practice regarding optimal surfactant dosing for preterm infants with RDS.
  • The study aims to contribute evidence-based recommendations to neonatal care guidelines.
  • Results will be disseminated through publications and conference presentations.
Abstract

Keywords:
neonatal intensive & critical careneonatologyrespiratory medicine (see thoracic medicine)

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