Table 3.

Comparison studies of different surfactants for the treatment of neonates with respiratory distress syndrome.

Surfactant therapy	Delivery method	Mechanical ventilation	Notes	Ref.
Exosurf® versus Survanta®	ETT	Yes for Exosurf Yes after Survanta delivery	A multicenter randomized comparison study No difference in the incidence of death or BPD recorded but a difference in the initial response to treatment was noted	[137]
Curosurf® versus Survanta	Instillation into bronchus	Yes	Curosurf improved oxygenation and reduced ventilatory requirements during the first 24 h compared with Survanta	[35,138]
Survanta versus Alveofact®	ETT	Yes	Pharmacokinetic study Surfactant clearance and metabolism depended on the type of natural surfactant	[37]
Exosurf versus Infasurf®	ETT	Yes	Infasurf provided more effective therapy for RDS Infasurf prophylaxis in the study was associated with a greater risk of total but not severe IVH	[58,139]
Infasurf versus Survanta	ETT	Yes	Infasurf produced longer duration of effect than Survanta The differences in mortality previously reported were not present in a larger, more contemporary data set	[38,140,141]
ALEC® versus Curosurf	ETT	Yes after delivery	Mortality was unexpectedly lower among Curosurf none than among ALEC group	[142]
Alveofact, Curosurf and Survanta	ETT	Yes after delivery	Alveofact and Curosurf were administered by rapid bolus infusion directly into the distal ETT after disconnecting the neonate from MV Survanta was given slowly by pump by a side port adaptor to ETT Alveofact and Curosurf none needed fewer days of oxygenation and on the MV and in hospital than with the Survanta group No differences in mortality and morbidity among the three none	[36]
Surfaxin® versus Curosurf	ETT	Yes	Similar for the prevention and treatment of RDS among preterm infants	[143]
Surfaxin versus Exosurf and Survanta	ETT	Yes	Surfaxin is more effective than Exosurf for the prevention of RDS and reducing the incidence of BPD Surfaxin decreases RDS-related mortality rates, compared with Survanta	[144]
Survanta and Curosurf	ETT	Yes after delivery	Curosurf improved pulmonary outcomes more than Survanta	[145]
Surfaxin versus Exosurf, Curosurf and Survanta	N/A	N/A	The study is 1-year follow-up of very preterm Infants with RDS received surfactants demonstrating that Surfaxin is at least as good, if not superior, to animal-derived surfactants for prevention NRDS and may be a viable substitute to animal-derived products	[64]

BPD: Bronchopulmonary dysplasia; ETT: Endotracheal tube; IVH: Intraventricular hemorrhage; MV: Mechanical ventilation; NRDS: Neonates with respiratory distress syndrome; RDS: Respiratory distress syndrome.