Is there evidence for a mortality difference between natural surfactants

摘要

I read with interest the recent paper by Ramanathan et al., that compared outcomes among neonates treated with different animal-derived surfactants. The authors' conclusion that poractant alfa may offer a survival advantage over calfactant or beractant contradicts everything we understand about the biology of natural surfactants, and virtually all prospective clinical data we have gathered for the past 30 years. They base their conclusion on a retrospective review using a limited administrative data set, an approach with inherent weaknesses that makes such a paradigm-shifting claim untenable.