BERACTANT

Survanta

Reviewed by Dr Simon Rowley, Dorothy Cooper
August 1996
Administration Newborn Drug Protocol Index Newborn Services Home Page

Dose and Administration

  1. Survanta 4 ml/kg via endotracheal tube. Usually administer a second dose after 6 - 12 hours.

Doctor / NS-ANP to administer. Further doses should be discussed with the Consultant but up to 4 doses can be administered in first 48 hours of life (i.e, no more frequently than every 6 hours).

Indications

Intubated Infant in Level 3

  1. Moderately severe respiratory distress syndrome.
  2. <= 30 week babies either administer early or same criteria as (3) below
  3. > 30 weeks. Diagnosis of RDS and an a/A ratio of <0.22.

Non ventilated infant in Level 2 (baby intubated for Surfactant administration as per Guideline ). Decision whether baby is transferred to Level 3 made by CCN on duty.

  1. Clinical/radiological evidence of respiratory distress syndrome.
  2. Gestational age >32/40.
  3. Age <72 hours.
  4. Current chest radiograph available.
  5. Increasing requirements e.g. FiO2 >50%, pH <7.25, PaO2 <7.0, CO2 >7.0 (or a/A <0.22).
  6. Arterial line in situ.

Contraindications and Precautions

  1. Use in < 600g infants not established.
  2. Hindu parents. Discuss with specialist and get consent.

Clinical Pharmacology

Natural New Zealand bovine lung extract with added phospholipids. Exogenous surfactant decreases surface tension, improves lung compliance and lung water clearance.

Survanta is cleared into lung tissue within hours. The lipids enter endogenous surfactant pathways.

No information is available on metabolism of the bovine surfactant proteins.

Possible Adverse Effects

  1. Instability during administration.
  2. Possible ETT blockage.
  3. Rapid changes in lung compliance and blood gases.
  4. Slight increased risk of pulmonary haemorrhage.
  5. Increased risk of nosocomial infections.

Special Considerations

  1. Should be used only after consultation with specialist.
  2. Doctor /NS-ANP to administer.
  3. Monitor O2 saturation, ECG continuously and blood gases and adjust ventilator/oxygen appropriately. Inspect Survanta for discolouration prior to use.
  4. Suction prior to administration if necessary.