Does surfactant type cause a differential proinflammatory response in preterm infants with respiratory distress syndrome?

Introduction: The objective of this study was to compare the pulmonary inflammatory response of premature infants with respiratory distress following instillation of one of two commonly available surfactant preparations. Methods: This was a prospective, randomized investigation of preterm infants who were less than 30 weeks of gestational age, weighed less than 1 kg at birth, and who qualified to receive surfactant. Infants with multiple congenital anomalies or whose mothers were taking anti-inflammatory medications were ineligible. Tracheal aspirates (TAs) were collected on days 1, 3, 5, and 7 and airway cytokines from TAs were assayed for interleukin (IL)-8 and IL-6. Results: Infants were evenly matched by gestation (26±2 days and 26±1 days [mean±SD], Surfactant A and B, respectively) and birth weight (730±141 g and 732±167 g). TA cytokine levels were not different between or within groups. Ventilator requirements and clinical outcomes were similar between the two groups. Conclusion: The postnatal airway inflammatory response observed in preterm infants is not altered by the instillation of either surfactant preparation.