{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T17:31:44Z","timestamp":1787679104485,"version":"build-2784847793"},"reference-count":41,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1998,11,1]]},"abstract":"<jats:sec><jats:title>Objective.<\/jats:title><jats:p>To investigate whether early (&amp;lt;1 hour after birth) surfactant administration would be superior to late treatment (2\u20136 hours after birth) in preterm infants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design.<\/jats:title><jats:p>Randomized controlled multicenter clinical trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods.<\/jats:title><jats:p>Prenatal randomization of all infants of 27 to 32 weeks' gestational age stratified by center after parental informed consent. Early treatment: 100 mg\/kg body weight bovine surfactant (SF-RI1, Alveofact; Dr K. Thomae, Biberach, Germany) to infants requiring intubation after birth. Late treatment: identical dosage to infants requiring intubation up to 6 hours of age with the fraction of inspired oxygen &amp;gt;0.4 at 2 to 6 hours after birth. Primary endpoint: the time on mechanical ventilation. Main secondary endpoints: mortality, bronchopulmonary dysplasia, intraventricular hemorrhage \u2265grade III, and periventricular leukomalacia. Sample size calculation: at least 280 infants to prove superiority of either approach (\u03b1 = 0.05; \u03b2 = 0.90).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>Enrollment of 317 infants, 154 randomized to early surfactant treatment, 163 to late surfactant treatment. Study infants (all following data intent-to-treat groups: early versus late surfactant) were similar with respect to: gestational age, 29.5 \u00b1 1.6 weeks versus 29.7 \u00b1 1.6 weeks; birth weight, 1227 \u00b1 367 g versus 1269 \u00b1 334 g; and the rate of prenatal corticosteroids, 79.9% versus 72.8%. Duration of mechanical ventilation: 3 days (0\u20138) versus 2 days (0\u20136) (median, interquartile); further outcome variables: death or bronchopulmonary dysplasia (day 28) 25.9% versus 23.9%, mortality 3.2% versus 1.8%, intraventricular hemorrhage \u2265grade III 6.5% versus 3.7%, and periventricular leukomalacia 5.2% versus 5.5% not differing statistically.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>In preterm infants with a high rate of prenatal glucocorticoids, early surfactant administration was not found to be superior to late treatment in terms of relevant outcome variables.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.102.5.1153","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:44:32Z","timestamp":1092440672000},"page":"1153-1160","source":"Crossref","is-referenced-by-count":45,"title":["Early Versus Late Surfactant Treatment in Preterm Infants of 27 to 32 Weeks' Gestational Age: A Multicenter 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