Poractant alfa versus bovine lipid extract surfactant: prospective comparative effectiveness study

To compare short term respiratory outcomes in preterm infants treated with bovine lipid extract surfactant or poractant alfa.

Prospective comparative effectiveness cohort study of infants <32 weeks' gestational age requiring surfactant in thirteen centers. Each center provided bovine lipid extract surfactant for a set period of time in the year 2019 and then changed to poractant alfa for the remainder of the year. The primary outcome was total duration of respiratory support.

968 infants were included. 494 received bovine lipid extract surfactant and 474 received poractant alfa. No difference was observed in the total duration of respiratory support (mechanical ventilation or non-invasive) (median 38 vs 40.5 days), need to re-dose surfactant, bronchopulmonary dysplasia, survival to discharge, or length of admission.

In this pragmatic study, we did not identify any difference in short term outcomes between the groups based on the type of surfactant received.