12- Surfactant Replacement Therapy

Question 1

Surfactant-replacement therapy

Answer 1

Involves the instillation of artificially derived surfactant directly into the lungs
-There are two strategies for intubation: Rescue and prophylactic

Question 2

Prophylactic strategy

Answer 2

-Occurs as soon as possible in a newborn at high risk for developing RDS.
-Instillation of surfactant in the delivery room (Within minutes of birth)
-Helps prevents iatrogenic lung injury and improve oxygenation and ventilation.

Question 3

Beractant (Survanta)

Answer 3

-4 mL/kg in 4 aliquots
-Repeat every 6 hours for the first 24 hours

Question 4

Calfactant (Infasurf)

Answer 4

-3 mL/kg in 2 aliquots
-Every 12 hours, up to a maximum of 3 doses

Question 5

Poractant Alfa (Curosurf)

Answer 5

-First dose: 2.5 mL/kg in 2 aliquots
-Repeat dose; 1.25 mL/kg in 2 aliquots
-Every 12 hours, up to a max of 3 doses

Question 6

Equipment necessary for surfactant-replacement

Answer 6

-A 5-10 cc Syringe (containing the entire surfactant dose)- Warmed to room temperature
-A catheter for delivery of surfactant
-A resuscitation bag
-Suction equipment
-Intubation supplies, if the patient does not already have an endotracheal tube

Question 7

Technique for surfactant-replacement therapy

Answer 7

-Promote even distribution of surfactant within the lungs
-Usually based on manufacturer recommendations