{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:16:06Z","timestamp":1787242566124,"version":"build-2736575974"},"reference-count":32,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1998,4,1]]},"abstract":"<jats:p>Aim.\u2003To determine if 1-minute instillation of Curosurf via a dual-lumen endotracheal tube without interruption of mechanical ventilation could decrease the incidence of hypoxia (drop in oxygen saturation [Sao2] to &amp;lt;80%, or of transcutaneous partial pressure of oxygen [Ptco2] to &amp;lt;50 mm Hg [6.6 kPa]) and bradycardia (heart rate below 80 beats\/minute) at dosing, without affecting the efficacy of the standard bolus delivery.<\/jats:p>\n                  <jats:p>Design.\u2003Prospective, multicenter, randomized, nonblinded clinical trial.<\/jats:p>\n                  <jats:p>Setting.\u2003Neonatal intensive care units of the Spanish Surfactant Collaborative Group.<\/jats:p>\n                  <jats:p>Patients and Methods.\u2003One hundred ninety-eight infants (birth weight 600\u20132000 g) with respiratory distress syndrome needing mechanical ventilation with a fraction of inspired oxygen [Fio2] \u22650.40 were randomized before 24 hours to receive 200 mg\/kg of Curosurf, either by bolus instillation (n = 99) or by a simplified dosing technique (n = 99), giving the full dose in 1 minute via a dual-lumen endotracheal tube without positioning, interruption of mechanical ventilation, or bagging. Two additional doses (100 mg\/kg) were given within 12 and 24 hours of first dose, by the same method, if the infant still needed mechanical ventilation and had a Fio2 \u22650.30. The effects of both procedures on the incidence of acute adverse events at dosing, gas exchange, ventilator requirements, and outcome at 28 days were compared.<\/jats:p>\n                  <jats:p>Results.\u2003Fewer episodes of hypoxia (18 vs 40% of doses), and a smaller decrease in heart rate and Sao2were observed in the dual-lumen group. Efficacy of surfactant, based on improvement of oxygenation, ventilator requirements, and number of doses required, was similar in both groups. Infants in the dual-lumen group had a lower total time exposure to supplemental oxygen (195 \u00b1 199 vs 266 \u00b1 221 hours). No differences in the incidence of air leaks, intraventricular hemorrhage, patent ductus arteriosus, bronchopulmonary dysplasia, or survival were observed.<\/jats:p>\n                  <jats:p>Conclusion.\u2003A simplified 1-minute Curosurf dosing procedure via a dual-lumen endotracheal tube without fractional doses, ventilator disconnection, changes in the infant's position, or manual bagging was found to reduce the number of dosing-related adverse transient episodes of hypoxia. Although the simplified method appeared to be as effective as bolus delivery, this should be confirmed in a larger trial.<\/jats:p>","DOI":"10.1542\/peds.101.4.e4","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T19:44:32Z","timestamp":1092426272000},"page":"e4-e4","source":"Crossref","is-referenced-by-count":23,"title":["A Randomized Comparison of Surfactant Dosing via a Dual-lumen Endotracheal Tube in Respiratory Distress Syndrome"],"prefix":"10.1542","volume":"101","author":[{"given":"Adolf","family":"Valls-i-Soler","sequence":"first","affiliation":[{"name":"From the Neonatal Division and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Begon\u0303a","family":"Ferna\u0301ndez-Ruanova","sequence":"additional","affiliation":[{"name":"Research Unit, and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon Lo\u0301pez-Heredia","family":"y Goya","sequence":"additional","affiliation":[{"name":"From the Neonatal Division and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lourdes Roma\u0301n","family":"Etxebarr\u0131\u0301a","sequence":"additional","affiliation":[{"name":"From the Neonatal Division and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Rodriguez-Soriano","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hospital de Cruces, Osakidetza, Basque University School of Medicine, Bilbao, Bizkaia, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentin","family":"Carretero (Caceres)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Spanish Surfactant Collaborative Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[1998,4,1]]},"reference":[{"key":"2021121000305982900_B1","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":"2021121000305982900_B2","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1542\/peds.88.1.10","article-title":"Improved neonatal survival following multiple doses of bovine surfactant in very premature neonates at risk for respiratory distress syndrome.","volume":"88","author":"Hoekstra","year":"1991","journal-title":"Pediatrics."},{"key":"2021121000305982900_B3","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/S0140-6736(80)90489-4","article-title":"Artificial surfactant therapy in hyaline membrane disease.","volume":"1","author":"Fujiwara","year":"1980","journal-title":"Lancet."},{"key":"2021121000305982900_B4","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1172\/JCI111280","article-title":"Surfactant and pulmonary blood flow distribution following treatment of premature lambs with natural surfactant.","volume":"73","author":"Jobe","year":"1984","journal-title":"J Clin Invest."},{"key":"2021121000305982900_B5","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1164\/ajrccm\/141.3.743","article-title":"Effect of volume and dose on the pulmonary distribution of exogenous surfactant administered to normal rabbits or to rabbits with oleic lung injury.","volume":"141","author":"Gilliard","year":"1990","journal-title":"Am Rev Respir Dis."},{"key":"2021121000305982900_B6","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1159\/000457601","article-title":"Clinical experience with exogenous natural surfactants.","volume":"13","author":"Halliday","year":"1989","journal-title":"Dev Pharmacol Ther."},{"key":"2021121000305982900_B7","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1542\/peds.88.1.19","article-title":"Reduction of neonatal mortality after multiple doses of bovine surfactant in low birth weight neonates with respiratory distress syndrome.","volume":"88","author":"Liechty","year":"1991","journal-title":"Pediatrics."},{"key":"2021121000305982900_B8"},{"key":"2021121000305982900_B9","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1159\/000244085","article-title":"Surfactant bolus instillation: effects of different doses on blood pressure and cerebral flow velocities.","volume":"66","author":"Rey","year":"1994","journal-title":"Biol Neonate."},{"key":"2021121000305982900_B10","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1136\/adc.66.10_Spec_No.1105","article-title":"Cerebral blood flow velocity changes after rapid administration of surfactant.","volume":"66","author":"Cowan","year":"1991","journal-title":"Arch Dis Child."},{"key":"2021121000305982900_B11","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1111\/j.1651-2227.1994.tb13169.x","article-title":"Cerebral blood flow and plasma hypoxanthine in relation to surfactant treatment.","volume":"83","author":"Bell","year":"1994","journal-title":"Acta Paediatr."},{"key":"2021121000305982900_B12","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1542\/peds.89.4.643","article-title":"Cerebroelectrical depression following surfactant treatment in preterm neonates.","volume":"89","author":"Hellstro\u0308m-Westas","year":"1992","journal-title":"Pediatrics."},{"key":"2021121000305982900_B13"},{"key":"2021121000305982900_B14"},{"key":"2021121000305982900_B15","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1007\/BF00443108","article-title":"Acute and protracted effects of intratracheal surfactant application on internal carotid blood flow velocity, blood pressure and carbon dioxide tension in very low birth weight infants.","volume":"148","author":"Jorch","year":"1989","journal-title":"Europ J Pediatr."},{"key":"2021121000305982900_B16","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1016\/S0022-3476(96)70291-3","article-title":"A multicenter randomized, masked comparison trial of natural versus synthetic surfactant for the treatment of respiratory distress syndrome.","volume":"128","author":"Hudak","year":"1996","journal-title":"J Pediatr."},{"key":"2021121000305982900_B17","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1203\/00006450-199310000-00021","article-title":"Pulmonary distribution and efficacy of exogenous surfactant in lung lavaged rabbits are influenced by the instillation technique.","volume":"34","author":"Segerer","year":"1993","journal-title":"Pediatr Res."},{"key":"2021121000305982900_B18"},{"key":"2021121000305982900_B19","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1164\/ajrccm\/147.1.218","article-title":"Surfactant and the adult respiratory distress syndrome.","volume":"147","author":"Lewis","year":"1993","journal-title":"Am Rev Respir Dis."},{"key":"2021121000305982900_B20","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/S0022-3476(05)83440-7","article-title":"Comparison of three dosing procedures for administration of bovine surfactant to neonates with respiratory distress syndrome.","volume":"122","author":"Zola","year":"1993","journal-title":"J Pediatr."},{"key":"2021121000305982900_B21","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1111\/j.1651-2227.1997.tb08579.x","article-title":"A simplified surfactant dosing procedure in respiratory distress syndrome: the \u201cside-hole\u201d randomized study.","volume":"86","author":"Valls-i-Soler A, Lo\u0301pez-Heredia J, Ferna\u0301ndez-Ruanova MB, Gastiasoro Cuesta E for the Spanish Surfactant Collaborative Group","year":"1997","journal-title":"Acta Paediatr."},{"key":"2021121000305982900_B22","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1111\/j.1399-6576.1995.tb04207.x","article-title":"The effect of multiple small doses of exogenous surfactant on experimental respiratory failure induced by lung lavage in rats.","volume":"39","author":"Alvarez","year":"1995","journal-title":"Acta Anesth Scand."},{"key":"2021121000305982900_B23","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1152\/jappl.1991.70.2.869","article-title":"Aerosolized surfactant treatment of preterm lambs.","volume":"70","author":"Lewis","year":"1991","journal-title":"J Appl Physiol."},{"key":"2021121000305982900_B24"},{"key":"2021121000305982900_B25","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1152\/jappl.1994.76.1.45","article-title":"Distribution of surfactant and ventilation in surfactant-treated preterm lambs.","volume":"76","author":"Ueda","year":"1994","journal-title":"J Appl Physiol."},{"key":"2021121000305982900_B26","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1164\/ajrccm\/148.5.1187","article-title":"Aerosolized versus instilled exogenous surfactant in a nonuniform pattern of lung injury.","volume":"148","author":"Lewis","year":"1993","journal-title":"Am Rev Respir Dis."},{"key":"2021121000305982900_B27","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1159\/000244286","article-title":"Rapid tracheal infusion of surfactant versus bolus instillation in rabbits: effects on oxygenation, blood pressure and surfactant distribution.","volume":"69","author":"Segerer","year":"1996","journal-title":"Biol Neonate."},{"key":"2021121000305982900_B28","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1203\/00006450-199205000-00006","article-title":"Short-term distribution kinetics of intratracheal administered exogenous lung surfactant.","volume":"31","author":"Davis","year":"1992","journal-title":"Pediatr Res."},{"key":"2021121000305982900_B29","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1203\/00006450-199704000-00006","article-title":"Acute effects on systemic and pulmonary hemodynamics of intratracheal instillation of porcine surfactant or saline in surfactant-depleted newborn piglets.","volume":"41","author":"Moen","year":"1997","journal-title":"Pediatr Res."},{"key":"2021121000305982900_B30"},{"key":"2021121000305982900_B31","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1203\/00006450-199608000-00006","article-title":"Hemodynamics and tissue blood flow after porcine surfactant replacement in surfactant-depleted newborn piglets.","volume":"40","author":"Moen","year":"1996","journal-title":"Pediatr Res."},{"key":"2021121000305982900_B32","first-page":"348","article-title":"Factors associated with surfactant treatment response in infants with severe respiratory distress syndrome.","volume":"83","author":"Charon","year":"1989","journal-title":"Pediatrics."}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/101\/4\/e4\/828355\/e4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/101\/4\/e4\/828355\/e4.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,29]],"date-time":"2023-04-29T01:32:30Z","timestamp":1682731950000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/101\/4\/e4\/62057\/A-Randomized-Comparison-of-Surfactant-Dosing-via-a"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1998,4,1]]},"references-count":32,"journal-issue":{"issue":"4","published-online":{"date-parts":[[1998,4,1]]},"published-print":{"date-parts":[[1998,4,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.101.4.e4","relation":{},"ISSN":["1098-4275","0031-4005"],"issn-type":[{"value":"1098-4275","type":"electronic"},{"value":"0031-4005","type":"print"}],"subject":[],"published":{"date-parts":[[1998,4,1]]}}}