Objective: To systematically compare the efficacy and safety of porcine and bovine pulmonary surfactant (PS) in the treatment of neonatal respiratory distress syndrome (NRDS). Methods: CNKI

VIP

Wanfang data

EMBase

the Cochrane Library and PubMed database were retrieved to collect the randomized controlled trials (RCT) of porcine and bovine PS in the treatment of NRDS. The retrieval time was from the establishment of the database to Jun. 2019. Two investigators independently performed literature screening

data extraction and quality assessment

and Meta-analysis was performed by using RevMan 5.3 and Stata 12.0 software. Results: A total of 22 RCT were collected

including 2

351 children. Meta-analysis showed that the mortality rate

re-administration rate of PS

oxygen exposure time and air leakage

bronchopulmonary dysplasia (BPD) and patent ductus arteriosus (PDA) of the porcine PS group were lower than those of the bovine PS group

the extubation rate at 72 h was higher than that of the bovine PS group (P<0.05). The differences in the incidence of pulmonary hemorrhage

sepsis

length of stay

neonatal necrotizing enterocolitis (NEC) and ventilator-associated pneumonia (VAP) were not statistically significant between two groups (P>0.05). Conclusion: Available evidence suggests that compared with bovine PS

porcine PS for NRDS is more effective in reducing the mortality rate and re-administration rate of PS

increasing the extubation rate at 72 and shortening the oxygen exposure time

with a lower risk of complications. Further large scale

high quality RCT are needed for validation due to the limitations of the included sample size and quality of the literature.