A Cochrane review [Abstract] 1 included 2 studies with a total of 1 037 subjects. Infants who received protein containing synthetic surfactant compared to animal derived surfactant extract did not demonstrate significantly different risks of mortality at 36 weeks (typical RR 0.81, 95% CI 0.64 to 1.03), chronic lung disease at 36 weeks (typical RR 0.99, 95% CI 0.84 to 1.18), or the combined outcome of mortality or chronic lung disease at 36 weeks (typical RR 0.96, 95% CI 0.82 to 1.12). A decrease in the risk of necrotizing enterocolitis was noted in infants who received protein containing synthetic surfactants (typical RR 0.60, 95% CI 0.42 to 0.86) but there was moderate heterogeneity between the studies.
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