The other night we had a baby that was sort of borderline intubate vs CPAP baby. I believe he was 34-35 wks or so. His x-ray showed mild RDS (supposedly--I didn't see it). Well, the neo decides that he should be intubated, given survanta, then immediately extubated. Basically use the ETT to deliver survanta, then remove.
Dose this just seem screwy to anyone else? I always thought they should stay intubated for awhile to maintain good pressure and expansion. Luckily the neo decided not to do it, they just put him on CPAP and didn't give survanta. The nurses and RT's were not comfortable with it. I mean, it is LIQUID we're putting into their LUNGS, and wouldn't it SUCK if the baby crumped on you and you didn't have an AIRWAY?!
Anyone else seen this done?
Aug 8, '02
We've intubated for the sole reason of giving Survanta a few times. It's usually the 33 plus weekers with RDS on CPAP. Or if they've had it at birth and needed a repeat dose the next day. I've never seen any complications from it and as far as the fluid, it's not really the same as putting NSS down the tube. Survanta is more like something you already have in your lungs isn't it ?
And you should already have good pressures from your CPAP,right? And if worse come to worse you could re intubate. But like I said, I've never seen this.
Aug 8, '02
We have talked about doing this, but so far the Neos have elected to leave the tube in until we're sure babe doesn't need another dose of survanta.
Aug 8, '02
I've seen that done LOTS, KRV. Seems to be in vogue right now around here. did the kid go on CPAP after the treatment?
Aug 8, '02
If we get a kid that needs to be given Survanta, they usually intubated and give the dose. Do a follow-up CXR to see if they need to give another dose. If not, then they extubate a couple hours later.
Aug 9, '02
Prmenrs,
He never actually got it, just went straight to CPAP. I guess it's one of those things that we rarely, if ever, do. Therefore, we're all skeptical of it.
We usually leave the baby intubated at least long enough to see if we need a 2nd dose.
Aug 8, '02Occupation: NICU RN Joined: Oct '00; Posts: 2,537; Likes: 369We've intubated for the sole reason of giving Survanta a few times. It's usually the 33 plus weekers with RDS on CPAP. Or if they've had it at birth and needed a repeat dose the next day. I've never seen any complications from it and as far as the fluid, it's not really the same as putting NSS down the tube. Survanta is more like something you already have in your lungs isn't it ?
Aug 8, '02Occupation: Re-retired Specialty: 42 year(s) of experience in NICU, Infection Control ; From: CA, US ; Joined: Dec '00; Posts: 12,419; Likes: 3,760I've seen that done LOTS, KRV. Seems to be in vogue right now around here. did the kid go on CPAP after the treatment?
Aug 9, '02Occupation: Level III NICU Specialty: NICU ; From: US ; Joined: Oct '00; Posts: 1,605; Likes: 929Prmenrs,
