Published online June 1, 2006
PEDIATRICS Vol. 117 No. 6 June 2006, pp. 2324-2325 (doi:10.1542/peds.2006-0469)
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Lucinactant Versus Poractant-{alpha} in Premature Lambs

Henry L. Halliday, MD
Child Health
Queens University of Belfast
Institute of Clinical Science
Belfast BT9 5JY, Northern Ireland

Christian P. Speer, MD
Department of Pediatrics
University Children's Hospital
97080 Wurzburg, Germany

To the Editor.—

We were surprised to see in the abstract of the article by Gastiasoro-Cuesta et al1 that "lucinactant produced improvements in gas exchange and lung mechanics similar to those observed with a porcine-derived surfactant" was not supported by the findings reported in the text of the publication.

PULMONARY GAS EXCHANGE

From their Table 2 it is clear that arterial oxygen pressures increased much more rapidly in the poractant-{alpha} group, and the differences were sustained for at least 60 minutes despite alteration of ventilator settings (see below). This is not discussed in their results section but is alluded to in their discussion: "Lucinactant-treated lambs had a slower PaO2 increase (Table 2), which should not be considered a negative result...." However, this result was not reported in their abstract.

PULMONARY MECHANICS

Although it is agreed that reported figures for dynamic compliance are similar between groups after surfactant treatment (see their Fig 2), it should be noted that the mean airway pressures are significantly higher in the lucinactant group than the poractant-{alpha} group (see their Fig 1). Ventilator settings after surfactant administration were "changed to maintain adequate arterial blood gas levels," which was why significantly higher peak inspiratory and mean airway pressures along with inspiratory time and expiratory time "were required for the lucinactant-treated lambs, to maintained adequate gas exchange." This result was not reported in their abstract.

OTHER POINTS

One third of the lucinactant-treated lambs (2 of 6) did not respond to treatment with an increase in PaO2, whereas "[a]ll animals in the poractant-{alpha} group responded to surfactant treatment." This result was not reported in their abstract.

We do not see how the authors could claim in their abstract that "lucinactant produced improvements in gas exchange and lung mechanics similar to those observed with a porcine-derived surfactant." We are also disappointed that this matter slipped by unnoticed by the editors of Pediatrics, because they request that their reviewers draw specific attention to discrepancies between the contents of abstracts and the findings reported in manuscripts submitted for publication. Readers will need to look beyond the abstract to discover the true findings of this article.

FOOTNOTES

Financial Disclosure: We freely declare a potential conflict of interest in that we have received speakers' fees from various companies making and distributing surfactants, including Abbott, Burroughs-Wellcome, Chiesi, and Dey. In addition, we have received support from Chiesi for clinical trials and consultancy fees.

REFERENCE

  1. Gastiasoro-Cuesta E, Alvarez-Diaz FJ, Rey-Santano C, Arnaiz-Renedo A, Loureiro-Gonzalez B, Valls-i-Soler A. Acute and sustained effects of lucinactant versus poractant-{alpha} on pulmonary gas exchange and mechanics in premature lambs with respiratory distress syndrome. Pediatrics. 2006;117 :295 –303[Abstract/Free Full Text]
PEDIATRICS (ISSN 1098-4275). ©2006 by the American Academy of Pediatrics

Related articles in Pediatrics:

Lucinactant Versus Poractant-{alpha} in Premature Lambs: In Reply
Adolf Valls-i-Soler, Elena Gastiasoro-Cuesta, and Francisco J. Alvarez-Diaz
Pediatrics 2006 117: 2325. [Extract] [Full Text]  




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