Artificial Surfactant Replacement

Aka: Artificial Surfactant Replacement, Pulmonary Surfactant, Respiratory Surfactant, Exosurf, Beractant, Survanta, Calfactant, Infasurf

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II. Indications

  1. Infant Respiratory Distress Syndrome

III. Mechanism

  1. Surfactant replacement decreases lung surface tension, allowing for greater alveoli opening

IV. Medications

  1. Survanta (Beractant)
    1. Supplemented extract from calf lung
    2. Available in 25 mg/ml (vials contain 4 or 8 mls)
  2. Calfactant (Infasurf)
    1. Calf lung lavage extract
    2. Available in 35 mg/ml (vials contain 3 or 6 mls)
  3. Exosurf
    1. Synthetic surfactant analog

V. Dosing

  1. Surfactant delivery via Endotracheal Tube
  2. Dose 200 mg/kg for initial dose
  3. Followed by weaning Endotracheal Tube to Nasal CPAP

VI. Adverse Effects

  1. Pulmonary Hemorrhage
  2. During instillation via Endotracheal Tube
    1. Oxygen Desaturation
    2. Bradycardia

VII. Resources

  1. Calfactant (Infasurf)
    1. https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=315c128a-272d-4c57-bfbe-1a8b3402af08&type=display
  2. Beractant (Survanta) Suspension
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=7ef9e3a5-fc39-4ae1-0dad-6b47a1684635

VIII. References

  1. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 90

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