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

VIII. References

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

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Related Studies

Ontology: Pulmonary Surfactants (C0034085)

Definition (FMA) Secretion produced by Type 2 pulmonary alveolar cell.
Definition (UWDA) Secretion produced by Type 2 pulmonary alveolar cell.
Definition (NCI) Pulmonary surfactant lines the lung epithelium and lowers surface tension to prevent collapse at end-expiration. Deficiency of pulmonary surfactant results in respiratory distress syndrome (RDS) in premature infants. Lung surfactant is synthesized in alveolar type II cells, stored in lamellar bodies and secreted via exocytosis.
Definition (NCI_CDISC) Pulmonary surfactant lines the lung epithelium and lowers surface tension to prevent collapse at end-expiration. Deficiency of pulmonary surfactant results in respiratory distress syndrome (RDS) in premature infants. Lung surfactant is synthesized in alveolar type II cells, stored in lamellar bodies and secreted via exocytosis. (NCI)
Definition (MSH) Substances and drugs that lower the SURFACE TENSION of the mucoid layer lining the PULMONARY ALVEOLI.
Definition (CSP) phospholipids secreted by the great alveolar cells into alveoli and respiratory air passages which contributes to the elastic property of pulmonary tissue.
Concepts Pharmacologic Substance (T121) , Biologically Active Substance (T123) , Lipid (T119)
MSH D011663
SnomedCT 108637009, 20170008, 346667009
English Pulmonary Surfactant, Surfactant, Pulmonary, Surfactants, Pulmonary, pulmonary surfactant, PULM SURFACTANT, SURFACTANTS PULM, SURFACTANT PULM, PULM SURFACTANTS, Alveolar surfactant, pulmonary surfactants, lung surfactant, lungs surfactants, surfactant pulmonary, alveolar surfactant, lung surfactants, Lung surfactants, Lung surfactant preparation, Lung surfactant preparation (product), LUNG SURFACTANT, Lung surfactant, Pulmonary surfactant, Respiratory surfactant, Lung surfactant (substance), Respiratory surfactant (product), Lung surfactant preparation (substance), Respiratory surfactant (substance), Pulmonary Surfactants, Surfactant, Surfactant, Lung, Lung Surfactant
French Surfactants pulmonaires
Swedish Lungsurfaktanter
Czech plicní surfaktanty
Finnish Surfaktantit
Russian LEGOCHNYE SURFAKTANTY, LEGOCHNYE PAV, LEGOCHNYE POVERKHNOSTNO-AKTIVNYE VESHCHESTVA, SURFAKTANTY LEGOCHNYE, ЛЕГОЧНЫЕ ПАВ, ЛЕГОЧНЫЕ ПОВЕРХНОСТНО-АКТИВНЫЕ ВЕЩЕСТВА, ЛЕГОЧНЫЕ СУРФАКТАНТЫ, СУРФАКТАНТЫ ЛЕГОЧНЫЕ
Italian Surfattante polmonare, Surfattanti polmonari
Croatian PLUĆNI SURFAKTANTI
Polish Surfaktanty płucne
Japanese 肺サーファクタント, サーファクタント-肺, 肺界面活性物質, 肺胞界面活性物質, 肺胞表面活性物質, 肺表面活性物質, 肺界面活性剤
Spanish preparado de surfactante pulmonar, preparado de surfactante pulmonar (producto), factor surfactante, preparado de surfactante pulmonar (sustancia), surfactante pulmonar (sustancia), surfactante pulmonar, surfactante respiratorio (producto), surfactante respiratorio (sustancia), surfactante respiratorio, Surfactantes Pulmonares
German Lungensurfactants, Pulmonale Surfactants, Surfactants, pulmonale, Oberflächenaktive Substanzen der Lunge
Portuguese Surfactantes Pulmonares

Ontology: beractant (C0105750)

Concepts Pharmacologic Substance (T121) , Lipid (T119)
MSH C072197
SnomedCT 391838009, 387225001, 40905005
English beractant, beractant (medication), surfactants beractant, beractant [Chemical/Ingredient], BERACTANT, A-60386X, Beractant - chemical, Beractant - chemical (substance), Beractant, Modified calf lung surfactant extract, Supplemented bovine lung homogenate, Surfactant TA, Surfactant Tokyo-Akita, Beractant (product), Beractant (substance), surfactant-TA
Spanish homogenato de pulmón bovino suplementado, homogenato de pulmón vacuno suplementado, beractante (producto), beractante (sustancia), beractante, extracto de surfactante pulmonar de ternero modificado, surfactante TA, surfactante Tokio-Akita

Ontology: Survanta (C0699934)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C072197
English Survanta, survanta, Ross brand of beractant, Abbott brand of beractant

Ontology: calfactant (C0763530)

Definition (NCI) A sterile suspension composed of an extract of bovine pulmonary surfactant with surfactant activity. Calfactant contains phospholipids, neutral lipids, and hydrophobic surfactant-associated proteins B (SP-B) and C (SP-C). Upon intratracheal administration, this agent, mimicking endogenous pulmonary surfactant, lines the alveoli and smallest bronchioles, keeping alveoli open during expiration by lowering surface tension. Resulting improvements in lung compliance and respiratory gas exchange may lead to improvements in ventilation and oxygenation.
Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH C117342
SnomedCT 108641008, 409376009
English calfactant, calfactant [Chemical/Ingredient], CALFACTANT, Calfactant (substance), Calfactant, Calfactant (product)
Spanish calfactante (sustancia), calfactante, calfactante (producto)