***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: Objective To compare the complications among preterm infants treated with two different natural surfactants .  Methods In a r and omized clinical trial , 150 preterm infants with Respiratory distress syndrome ( RDS ) treated with exogenous surfactant , were enrolled in the study . Group A consisted of 79 neonates that received poractant ( curosurf ) . Seventy one newborn infants in group B were treated with beractant ( Survanta ) . Results The mean gestational age for group A and B were 29.40±2.90 wk and 29.50±2.73 wk ( P=0.82 ) , respectively . The demographic and clinical variables were similar in both groups . The mean duration of intubation ( as a primary outcome ) was significantly shorter in infants treated with poractant ( 3.13±1.80 vs 4.06±2.7 days p=0.05 ) . The mean duration of need for oxygen and hospitalization of patients in group A and B were 17.73±22.25 vs 19.14±17.85 days ( p=0.67 ) and 24.89±26.41 vs 29.14±23.54 days ( p= 0.32 ) , respectively . There was no significant difference between groups with respect to mortality and morbidity , including pulmonary hemorrhage , intraventricular hemorrhage ( IVH ) , patent ductus arteriosus , sepsis , and bronchopulmonary dysplasia ( secondary outcome ) . Conclusions In this study , infants who  received poractant had shorter duration of intubation than infants treated with beractant , without any difference in the duration of oxygen therapy or hospitalization . There was no significant superiority of poractant over beractant Background Although several different types of natural surfactants are available , including Alveofact , Curosurf , and Survanta , the preferred type and the magnitude of their effects are unknown . Objectives This study was design ed to compare the effects of these three surfactants on the gas exchange and clinical outcomes of neonates with respiratory distress syndrome ( RDS ) . Methods This triple-blind r and omized clinical trial studied all preterm neonates ≤ 37 weeks with RDS who were admitted to the neonatal intensive care unit ( NICU ) of Taleghani hospital ( Tabriz , Iran ) between 2012 and 2013 . The patients were divided into three groups , each of which received one of these surfactants . The incidences of ventilator dependency , patent ductus arteriosus ( PDA ) , broncho-pulmonary dysplasia ( BPD ) , retinopathy of prematurity ( ROP ) , intraventricular hemorrhage ( IVH ) , hospital-stay length , and continuous positive airway pressure ( CPAP ) failure  , as well as blood gas levels , were recorded as endpoint measurements and compared . Results In total , 165 neonates of gestational age ≤ 37 weeks with RDS were examined . Neonates were allocated to three different groups r and omly , including a Survanta group ( n = 49 ) , a Curosurf group ( n = 62 ) , and an Alveofact group ( n = 54 ) . The mean gestational age of the neonates was 31.6 ± 3.7 weeks , and their mean weight was 1,840 ± 790 grams . The male/female ratio was 2:1 ( 67 % male , 33 % female ) ; 104 ( 63 % ) neonates were ≤ 32 weeks gestational age , and 61 ( 37 % ) were > 32 weeks . There were no significant differences for gender or demographic characteristics among the neonates in relation to the type of applied surfactant . According to the clinical parameters ( BPD , IVH , ROP , hospital-stay length , and mechanical ventilation requirement ) , no significant differences were observed between the groups before and after surfactant administration , but the differences between the Survanta and Alveofact groups for the incidence rates of pneumothorax ( P = 0.03 ) and pulmonary hemorrhage ( P = 0.03 ) were statistically significant . Conclusions No significant differences were observed in most of the clinical variables between the three types of natural surfactant , but in neonates ≤ 32 weeks , the incidence of pneumothorax was significantly higher in the Alveofact group ; in neonates > 32 weeks , the incidences of PDA , mean hospital-stay length , and mean mechanical ventilation time were also significantly higher in the same group . It thus appears that Curosurf and Survanta replacement therapies among premature neonates with RDS perform better than Alveofact replacement therapy Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Objective : Comparison of the differences between availability of animal-derived surfactant preparations used to treat premature infants is incomplete . The objective of this study was to assess the short-term treatment efficacy of the two most commonly used surfactant preparations in the United States , beractant ( 100 mg kg–1 initial and subsequent doses ) and poractant alfa ( 200 mg kg–1 initial and 100 mg kg–1 subsequent doses ) , in very premature , mechanically ventilated infants < 30 weeks gestation with respiratory distress syndrome ( RDS ) . Study Design : Inborn infants at two institutions , open label , 1:1 , r and omized controlled trial . Level of respiratory support for first 72 h of life . Morbidities of prematurity observed during the neonatal intensive care unit hospitalization . Result : We studied 52 infants 24 0/7 to 29 6/7 weeks gestation ; 25 received poractant alfa ( 27.1±1.6 weeks , birth weight of 930±231 g ) and 27 received beractant  ( 26.7±1.7 weeks , P=0.343 and birth weight 900±271 g , P=0.668 ) . Respiratory support for the first 72 h of life was lower in the poractant alfa than beractant group for mean airway pressure ( MAP , P=0.003 ) and respiratory index ( MAP × FiO2 , P=0.032 ) . Infants in the poractant alfa group had a greater number of infants extubated at 48 ( 13/25 vs 6/27 , P=0.027 ) and 72 h ( 15/25 vs 8/27 , P=0.029 ) than the beractant group . Although the study was not powered to detect morbidities of prematurity , the prevalence of PDA and air leaks was less in the infants treated with poractant alfa than in those treated with beractant  . Rates of bronchopulmonary dysplasia ( 8/23 vs 11/22 , P=0.303 ) or death ( 2/15 vs 5/27 , P=0.272 ) were similar in the infants treated with poractant alfa and beractant , respectively . Conclusion : This study suggests significant short-term benefits to the use of the larger initial dose of poractant alfa than beractant in very premature infants with RDS . Further studies involving a larger number of preterm infants are needed to assess long-term effects AIMS --To compare treatment regimens of two widely used natural surfactant preparations Curosurf and Survanta in respiratory distress syndrome ( RDS ) . METHODS --The effects of the two treatment regimens on gas exchange , ventilatory requirements , and 28 day outcome in infants with RDS were compared . Seventy five preterm infants ( birth weight 700 - 1500 g ) with RDS requiring artificial ventilation with an FIO2 of > or = 0.4 , were r and omly selected at 1 - 24 hours of age . One group received an initial dose of Curosurf ( 200 mg/kg ) ; the other group Survanta ( 100 mg/kg ) . Patients who remained dependent on artificial ventilation with an FIO2 of > or = 0.3 received up to two additional doses of Curosurf ( each of 100 mg/kg ) after 12 and 24 hours or up to three additional doses of Survanta ( each of 100 mg/kg ) between six and 48 hours after the initial dose . RESULTS --There was a rapid improvement in oxygenation and ventilatory requirements were reduced in both groups . However , infants treated with Curosurf had a higher arterial : alveolar oxygen tension ratio and required a lower peak inspiratory pressure and mean airway pressure at several time points within 24 hours of r and omisation ( p < 0.05 - 0.001 ) . The incidences of pneumothorax in the Curosurf and Survanta groups were 6 % and 12.5 % , respectively ; the corresponding figures for grade s 3 - 4 intracerebral haemorrhage were 3 % and 12.5 % , respectively . Mortality was 3 % in the Curosurf group and 12.5 % in the Survanta group . However , these differences did not reach significance . CONCLUSION --The Curosurf treatment regimen result ed in a more rapid improvement in oxygenation than Survanta and reduced ventilatory requirements up to 24 hours after start of treatment . This was associated with a trend towards reduced incidence of serious pulmonary and non-pulmonary complications Current practice guidelines recommend administration of surfactant at or soon after birth in preterm infants with respiratory distress syndrome . However , recent multicenter r and omized controlled trials indicate that early use of continuous positive airway pressure with subsequent selective surfactant administration in extremely preterm infants results in lower rates of bronchopulmonary dysplasia/death when compared with treatment with prophylactic or early surfactant therapy . Continuous positive airway pressure started at or soon after birth with subsequent selective surfactant administration may be considered as an alternative to routine intubation with prophylactic or early surfactant administration in preterm infants Background : Bronchopulmonary dysplasia ( BPD ) is a commonly used outcome for r and omized neonatal trials . Objectives : The aim of the present study was to determine whether a diagnosis of BPD or respiratory morbidity ( RM1 or RM2 ) at 12 months corrected age better predicted subsequent RM in extremely low gestational age infants ( 23 - 28 weeks of gestation ) . Methods : Initial analysis was undertaken in a development cohort of 76 infants who underwent pulmonary function tests ( PFTs ) at 12 months corrected age . Parents completed infant respiratory diaries 2 weeks before the PFTs . Analysis was then undertaken in a validation cohort of 227 infants whose parents completed a 4-week respiratory diary when their infant was 12 months corrected age . BPD at 28 days ( BPD28d ) and 36 weeks post-menstrual age ( BPD36w ) , RM1 ( ≥3 days and /or nights of cough , wheeze , and /or medicine use ) and RM2 ( ≥4 days and /or nights of cough , wheeze , and /or respiratory medicine use ) each week for 2 weeks at 12 months corrected age were assessed with regard to prediction of respiratory outcomes at 24 months documented by respiratory health question naires . Results : BPD28d and BPD36w were not significantly associated with any respiratory outcome . Areas under the receiver operating characteristic curves were significantly better for either definition of RM than BPD28d or BPD36w for all outcomes . Conclusions : RM documented by parental completed diaries at 12 months corrected age better predicted respiratory outcome at 24 months corrected age than BPD regardless of diagnostic criteria Introduction The benefit of surfactant prescription for respiratory distress syndrome ( RDS ) has been approved . Curosurf and Survanta are two commonly used natural surfactants in Iran . Previous studies did not report priority for one of these two drugs . The present study aim ed to compare the effectiveness and safety of Curosurf and Survanta in treatment of RDS . Methods In this r and omized clinical trial , neonates were born with RDS diagnosis in two governmental and referral hospitals of Tehran ( the capital of Iran ) in 2014 were r and omly selected . Neonates were r and omly assigned into two groups receiving 100 mg/kg Curosurf or Survanta as soon as possible after r and omization . Complications , mortality and needing the second dose were compared between the two groups . Results A total 112 patients with the mean gestational age of 32.59 ± 3.39 weeks were evaluated ( 56 patients in each group ) . There were no significant differences regarding birth weight , gestational age , delivery method , and parity between the two groups ( P > 0.05 ) . The complications were occurred in 18 neonates ( 32.1 % ) of Curosurf group and 20 neonates ( 35.7 % ) of Survanta group ( RR = 0.922 , 95 % CI = 0.617–1.379 ) . There were no significant differences regarding complications , mortality , and needing nasal CPAP and endotracheal tube between the two groups . In the neonates with gestational age of 29–32 weeks the IVH and NEC incidence were significantly more in Curosurf group compared to Survanta group ( 27.8 % vs 0 % and 22.3 % vs 0 % , P < 0.05 ) . Conclusion There was no significant difference in complications or mortality between those two groups 
    Output:
    
Conclusion 200 mg/kg poractant-α is associated with better respiratory outcomes  compared to bovine surfactants at their licensed dose .
The effect of poractant-α  on BPD and surfactant retreatment is greater at lowest and highest gestational ages , respectively .