{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T02:25:06Z","timestamp":1774664706885,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2005,10,21]],"date-time":"2005-10-21T00:00:00Z","timestamp":1129852800000},"content-version":"vor","delay-in-days":4798,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[1992,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Of 95 infants treated with the synthetic surfactant, Exosurf\u00ae, under a Treatment Investigational New Drug protocol, 17 received one dose, 40 received two, and 38 received three doses. Seventy\u2010six (80%) of the infants were treated by rescue protocol. We retrospectively reviewed the clinical course of the 67 surviving rescue infants. We found that, compared to one\u2010and two\u2010dose infants, those treated with three doses of Exosurf\u00ae were more premature, smaller, required a longer ventilator course, and had more frequent complications, including patent ductus arteriosus (PDA), intraventricular hemorrhage, nosocomial pneumonia, and apnea. They required higher oxygen concentrations starting 8 hr after their first dose and higher mean airway pressure (MAP) from the time of their second dose. These trends continued during all subsequent time points, as compared to infants treated with two doses. The third dose was administered an average of 17 hr after the second, resulting in little change of MAP, but some reduction in oxygen requirements. By 24 hr after the last dose, only 4% of three\u2010dose infants were extubated compared with 30% of the two\u2010dose and 71% of one\u2010dose infants. In conclusion, repeated administration of Exosurf\u00ae is not equally effective in every treated infant with respiratory distress syndrome (RDS) and complications of prematurity may affect or accompany poor response. We speculate that (1) the group of infants treated with three doses of Exosurf\u00ae had a greater degree of surfactant deficiency than the other groups, (2) PDA may account for this refractory response to surfactant, and (3) the three\u2010dose group might have responded better to earlier treatment and\/or more surfactant doses, or to earlier PDA closure. \u00a9 1992 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/ppul.1950140105","type":"journal-article","created":{"date-parts":[[2007,3,6]],"date-time":"2007-03-06T17:56:12Z","timestamp":1173203772000},"page":"16-22","source":"Crossref","is-referenced-by-count":4,"title":["Exosurf\u00ae treatment investigational new drug phase: Effect of an individualized third dose in infants with respiratory distress syndrome"],"prefix":"10.1002","volume":"14","author":[{"given":"David","family":"Easa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Pelke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth T.","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janet","family":"Barrett","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Venkataraman","family":"Balaraman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sherry W. H.","family":"Loo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elenita","family":"Ibarra\u2010Pratt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha B.","family":"Smith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2005,10,21]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1542\/peds.82.5.683","article-title":"Surfactant replacement therapy for severe neonatal respiratory distress syndrome: An international randomized clinical trial","volume":"82","author":"Collaborative European Multicenter Study Group","year":"1988","journal-title":"Pediatrics"},{"key":"e_1_2_1_3_2","first-page":"756","article-title":"Surfactant replacement therapy at birth: Final analysis of a clinical trial and comparisons with similar trials","volume":"82","author":"Kendig JW","year":"1988","journal-title":"Pediatrics"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00442605"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198904133201502"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(05)82897-5"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02009663"},{"key":"e_1_2_1_8_2","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1542\/peds.85.6.1092","article-title":"Multicenter trial of single\u2010dose modified bovine surfactant extract (Survanta) for prevention of respiratory distress syndrome","volume":"85","author":"Soll RF","year":"1990","journal-title":"Pediatrics"},{"key":"e_1_2_1_9_2","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1542\/peds.86.4.564","article-title":"Single\u2010versus multiple\u2010dose surfactant replacement therapy in neonates of 30 to 36 weeks gestation with respiratory distress syndrome","volume":"86","author":"Dunn MS","year":"1990","journal-title":"Pediatrics"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(05)80143-X"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(05)80502-5"},{"key":"e_1_2_1_12_2","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1542\/peds.87.3.377","article-title":"Bovine surfactant replacement therapy in neonates of less than 30 weeks' gestation: A randomized controlled trial of prophylaxis versus treatment","volume":"87","author":"Dunn MS","year":"1991","journal-title":"Pediatrics"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(05)83387-6"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(05)83388-8"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199112123252404"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/136.5.1256"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.1988.02150120087047"},{"key":"e_1_2_1_18_2","first-page":"214A","article-title":"Effects of three vs. one prophylactic doses of Exosurf Neonatal in 700\u20101100 gm neonates","volume":"29","author":"Gerdes J","year":"1991","journal-title":"Pediatr Res"},{"key":"e_1_2_1_19_2","unstructured":"Burroughs Wellcome Exosurf Clinical Trials Protocols."},{"key":"e_1_2_1_20_2","unstructured":"Burroughs Wellcome Exosurf Treatment Investigational New Drug Protocol."},{"key":"e_1_2_1_21_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/137.4.943"},{"key":"e_1_2_1_22_2","first-page":"348","article-title":"Factors associated with surfactant treatment response in infants with severe respiratory distress syndrome","volume":"83","author":"Charon A","year":"1989","journal-title":"Pediatrics"},{"key":"e_1_2_1_23_2","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-199112000-00022"},{"key":"e_1_2_1_24_2","first-page":"1","article-title":"Initial clinical trial of Exosurf, a protein\u2010free synthetic surfactant, for the prophylaxis and early treatment of hyaline membrane disease","volume":"88","author":"Phibbs RH","year":"1991","journal-title":"Pediatrics"},{"key":"e_1_2_1_25_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/144.6.1376"},{"key":"e_1_2_1_26_2","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-199109000-00007"},{"key":"e_1_2_1_27_2","first-page":"234A","article-title":"Response 10 surfactant therapy in RDS infants with \u201cearly\u201d large left\u2010to\u2010right shunt PDA","volume":"29","author":"Shimada S","year":"1991","journal-title":"Pediatr Res"},{"key":"e_1_2_1_28_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/143.2.236"},{"key":"e_1_2_1_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.1950110214"},{"issue":"1","key":"e_1_2_1_30_2","first-page":"42","article-title":"New synthetic surfactant helps infants breathe more easily","volume":"4","author":"Pramanik AK","year":"1991","journal-title":"Neonatal Intensive Care"},{"key":"e_1_2_1_31_2","first-page":"203A","article-title":"Antibody response to bovine surfactant in preterm infants","volume":"29","author":"Bartmann P","year":"1991","journal-title":"Pediatr Res"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fppul.1950140105","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.1950140105","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,23]],"date-time":"2023-10-23T18:49:42Z","timestamp":1698086982000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.1950140105"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1992,9]]},"references-count":30,"journal-issue":{"issue":"1","published-print":{"date-parts":[[1992,9]]}},"alternative-id":["10.1002\/ppul.1950140105"],"URL":"https:\/\/doi.org\/10.1002\/ppul.1950140105","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[1992,9]]}}}