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The efficacy and safety of KL4-Surfactant in preterm infants with respiratory distress syndrome

Academic Article
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Overview

authors

  • Cochrane, Charles
  • Revak, S. D.
  • Merritt, A.
  • Heldt, G. P.
  • Hallman, M.
  • Cunningham, M. D.
  • Easa, D.
  • Pramanik, A.
  • Edwards, D. K.
  • Alberts, M. S.

publication date

  • January 1996

journal

  • American Journal of Respiratory and Critical Care Medicine  Journal

abstract

  • The present study was undertaken to determine if a synthetic peptide, KLLLLKLLLLKLLLLKLLLLK (KL4), in which K = lysine and L = leucine, in an aqueous dispersion of phospholipids (DPPC and POPG), would expand pulmonary alveoli and improve gas exchange in premature human infants with respiratory distress syndrome (RDS). The KL4 peptide was synthesized to resemble the amino acid pattern of surfactant protein B (SP-B). Forty-seven infants with RDS were treated within 4 h of birth with the KL4-peptide/phospholipid mixture, called KL4-Surfactant. The average arterial-to-alveolar oxygen tension ratios (a/A O2) of 39 patients included in efficacy analyses rose from pretreatment values of 0.14 +/- 0.02 (mean +/- SEM) to 0.40 +/- 0.04 (normal value > or = 0.40) by 12 h of age. Mean airway pressures and oxygenation index values fell concomitantly, and expansion of the lungs was observed on radiographs. The median duration of mechanical ventilation was 5.0 d. Of the 39 included infants, 29 required only a single dose. Radiographic data indicate that those patients requiring a second instillation of KL4-Surfactant but not showing a sustained rise in a/A O2 ratios did, in fact, exhibit expansion of alveoli in the lung. There were no RDS-related deaths; the incidence of complications was no higher than found in other comparable published studies. The data demonstrate that the synthetic peptide, KL4, which mimics the hydrophobic and hydrophilic pattern of SP-B, when formulated in an aqueous dispersion with the phospholipids DPPC and POPG, creates a strong and durable surfactant activity as judged by expansion of pulmonary alveoli and improvement of gas exchange in infants with RDS.

subject areas

  • Age Factors
  • Amino Acid Sequence
  • Apgar Score
  • Birth Weight
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Male
  • Models, Biological
  • Molecular Sequence Data
  • Peptides
  • Pulmonary Alveoli
  • Pulmonary Gas Exchange
  • Pulmonary Surfactants
  • Radiography, Thoracic
  • Respiration, Artificial
  • Respiratory Distress Syndrome, Newborn
  • Safety
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Identity

International Standard Serial Number (ISSN)

  • 1073-449X

Digital Object Identifier (DOI)

  • 10.1164/ajrccm.153.1.8542150

PubMed ID

  • 8542150
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Additional Document Info

start page

  • 404

end page

  • 410

volume

  • 153

issue

  • 1

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