Antenatal steroids speed maturation of the lung, increasing surfactant production and
decreasing the severity of RDS. The accepted treatment for RDS is surfactant therapy
via endotracheal (ET) tube. Replacement/supplementation in the alveoli by
commercially prepared surfactants via an endotracheal tube is the current method. In
order to dose an infant with surfactant they must be intubated for at least a short time.
Some infants may be rapidly extubated (“in and out dosing”). Most infants make
surfactant by 3 days of life.
Surfactant Preparations and Dosing Regimens
SurfactantTrade Dose
Name
Generic
Name
Preparation Manufacturer Amount
(ml/kg)
Interval
(hrs)
Survanta Beractant Bovine lung
mince extract
w/ added
DPPC,
tripalmitin &
palmitic acid
Abbott (USA) 4 6Curosurf Porcine
Surfactant
Porcine
lung
minced extract
Chiesi
Pharm.
(Italy)1st:2.5
subseq:
1.2512
Infasurf
Calf lung
surfactant
extract
Bovine lung
wash
Forrest
Pharm
(USA)3 12
Surfactant prophylaxis Given to high-risk infants (^) during
resuscitation (10after birth) - 30 minutes
Pro: surfactant pool is established before lung damage
occurs
Con: unnecessary treatment?
Surfactant treatment
Given to infants diagnosed with RDS (1-2 hours or even longer
after birth)Pro: overtreatment is avoided^
Con: delay in treatment may allow lung inflammation and
damage to occur
Versus