Curosurf Versus BLES in the Treatment of Preterm Neonates with Respiratory Distress Syndrome: A Randomized Clinical Trial

Background: Two natural surfactants, Curosurf and BLES, are commonly used for the treatment of respiratory distress syndrome (RDS). Animal-derived surfactants have different pharmacological and biochemical features, and these differences might influence their clinical efficacy and complications. Objectives: The present study aimed to compare the clinical effectiveness and complications of Curosurf and BLES in the management of preterm neonates with RDS. Methods: This randomized clinical trial was conducted on 160 neonates with RDS and a gestational age of ≤ 32 weeks. Patients were randomly assigned to two intervention groups to receive either Curosurf (n = 80) or BLES (n = 80). Complications of prematurity, mortality, and the effectiveness of surfactant therapy were compared between the study groups. Results: There were statistically significant differences between the Curosurf group and the BLES group in the length of hospital stay (20.3 ± 14.4 vs. 27.3 ± 18.8 days, P = 0.01), number of surfactant injections (1.2 ± 0.4 vs. 1.4 ± 0.4, P = 0.006), and need for a second dose (21.2% vs. 41.2%, P = 0.005). In terms of complications, both groups showed no considerable differences. Conclusions: Compared to BLES, Curosurf may be more effective in the treatment of preterm neonates with RDS. Further clinical trials with robust designs and long-term follow-up are needed to compare these surfactants.