Working on adjusting our surfactant policy. Trying to set a standard of how long after administration of surfactant we should be assess blood gases. For first and repeat doses.
Also interested in criteria differences for first and repeat doses of surfactant if possible (we use Survanta)
Is this for NICU or PICU? In PICU, we generally checked a gas 5-10 minutes after dose (and going back on vent) and hourly thereafter unless we did some major vent tweaking.
Blood gases are not very accurate measures because a baby throwing a temper tantrum for a minute can drastically change a blood gas value and make one think that that the baby is worse off than he actually is. If you want to assess how well surfactant is working, I would suggest using AC-VG mode on the ventilator and monitoring if your PIPs come down as well as how well your FiO2 is coming down- there should be O2 sat limits on your monitors to alert the nurse to be adjusting FiO2.