Surfactant use in premature infants

[Laura21]

I would like to know what is the policy/procedure for surfactant use in premature infants at other institutions. I have read that it has been recommended that any baby less than 28 wks should recieve surfactant on the warmer. I want to know if this is in fact is a common practice. Thank you.

[fergus51]

We did this at my last hospital, my current hospital does not. I have noticed the babies take longer to wean and more of them go home on O2 at my current hospital. Their lungs are worse down here.

[BittyBabyGrower, MSN, RN]

If kids under 35 weeks are intubated for distress upon admission we always give one dose of survanta...most kids under 30 weeks need 2. We have had much less BPD!

[dawngloves, BSN, RN]

We tend to use 30 weeks as a guide. Greater than that, it depends on how well the kid is moving air, how his x rays and gases look, ect.

[lisailovenicu]

I would like to know what is the policy/procedure for surfactant use in premature infants at other institutions. I have read that it has been recommended that any baby less than 28 wks should recieve surfactant on the warmer. I want to know if this is in fact is a common practice. Thank you.

WE first look at x ray and give to all infants that show RDS on x ray and then give additional doses every 6 hours if the baby is requiring 40% o2 or more for upto 3 doses...not that it's right but that's what we do.

[BittyBabyGrower, MSN, RN]

We were seeing an increase with pulmonary hemmorage with the 3 doses, so we try to limit it to only two. We also forgo the first x-ray now too...the first dose can actually be given in DR as a rescue dose if needed.

[SteveNNP, MSN, NP]

Hey all,

We recently developed a policy stating that all 32-weeks and younger babies get surfed within 15 minutes if birth regardless. Any other kid who shows RD and might have immature lungs gets surfed.

[KyElaine]

We tend to give surfactant in the del rm to all babies 28wks and under. Other than those, its pretty much determined by CXR and resp support needed. It seems that our docs are getting less eager to give to older babies unless absolutely necessary. As one doc told me, (as I was fretting over a baby with resp in the 110's and increasing O2 requirement), a little distress wont kill this baby- but a pulmonary hemorrhage could. The baby still ended up getting 2 doses, but it made me more aware of the potential risk we sometimes forget about.

[MsJessikia]

gosh, it seems like everyone gets survanta in our unit. Im going to say under 32 wks is an automatic. Older than that.... it depends on their resp. status, admit xray, etc.

[Mimi2RN, ASN, RN]

We use Curosurf, routinely