What type of surfactant do you use?

iceNICUnurse · Aug 29, 2005

Infasurf? Survanta? Other? Do you know what I'm talking about? :chuckle
How many doses, typical?Any complications?
If you've recently switched from one brand to another. how does it compare?

Hi!

We use Curosurf and have been using it for a long time. We start out with one dose and then the docs tend to play it by ear. If the baby is asking for a lot more 02 then they give a second dose but othervise they try to hang on and see what happens. Usually they dont give more than 3 doses tho.

We have had quite good results with this and most of our babies are extubated within a week and put on CPAP.

Greetings from Iceland

iceNICUnurse

Jolie, BSN · Aug 29, 2005

Infasurf? Survanta? Other? Do you know what I'm talking about? :chuckle
How many doses, typical?Any complications?
If you've recently switched from one brand to another. how does it compare?

dawngloves,

This is an interesting question to me. About 20 years ago, I worked in a unit which was part of the clinical trials for what became known as Survanta. While surfactant certainly had a positive effect on our preemies with RDS, Survanta did not curry a lot of favor with our physicians and staff because of its complicated method of administation and unpredictable results.

A few years later, Exosurf became available and initially seemed to be more favored because it was easy to administer and required no special preparation or refrigeration.

Over the years, Exosurf seemed to fade from use, although I don't know why. I tend to suspect that many hospitals thought it too expensive to keep both drugs on hand, but why did Survanta "win out"? Was it a matter of marketing, or is it really a better product?

I've not worked in a number of years, and am not at all familiar with Infasurf. How does it differ from the others?

Gompers, BSN, RN · Aug 29, 2005

We used to use Survanta, and now we use Curosurf.

It does have to be refridgerated, but we have a couple of med fridges so it's not a problem. It's administered by a nurse and a respiratory therapist - one bags while the other instills, and both help change the baby's position.

We like it a lot better because the volume is much smaller and the dosage interval is longer. We will give one dose to any intubated preemie or meconium aspiration. Once in a while we'll give it to a borderline preemie and immediately extubate to Vapotherm. Those who stay intubated get anywhere from 1 to 4 doses, with the average being 2 doses. If the baby has poor gases, increasing ventilator settings, and an oxygen requirement >30%, that's grounds for another dose.

dawngloves, BSN, RN · Aug 30, 2005

Jolie,

Infasurf is relatively new. It is an extract of calves lungs.

All,

How about ETT plugging? Is that a complication with your surfactant?

JVanRN · Aug 30, 2005

We give Survanta. I haven't worked in Neo long (1 yr 2mos) so that's the only one I know of. We don't suction for up to 6 hours post administration. Sometimes it does clog the tube to the point the baby desats and you have to suction some of it out to clear the tube. I don't know if this is a problem with other surfactants. I've only helped administer it a couple of times so I'm not that up on it. I know here the doctor administers it while a nurse helps position the baby and assists with whatever else is needed. The babies seem to do good with it.