BERACTANT
Survanta
|
Reviewed by Dr Simon
Rowley, Dorothy Cooper |
| August 1996
|
Dose and Administration
- 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).
- Inject in boluses through 6 FG catheter
inserted into ETT.
- Judge size of boluses according to baby’s
tolerance.
- Ventilate between boluses for baby to
recover.
- Administer over a few minutes, as fast as
baby tolerates it.
- Baby supine and flat throughout.
Indications
Intubated Infant in Level 3
- Moderately severe respiratory distress syndrome.
- <= 30 week babies either administer early or
same criteria as (3) below
- > 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.
- Clinical/radiological evidence of respiratory
distress syndrome.
- Gestational age >32/40.
- Age <72 hours.
- Current chest radiograph available.
- Increasing requirements e.g. FiO2
>50%, pH <7.25, PaO2
<7.0, CO2 >7.0 (or
a/A <0.22).
- Arterial line in situ.
Contraindications and Precautions
- Use in < 600g infants not established.
- 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
- Instability during administration.
- Possible ETT blockage.
- Rapid changes in lung compliance and blood gases.
- Slight increased risk of pulmonary haemorrhage.
- Increased risk of nosocomial infections.
Special Considerations
- Should be used only after consultation with
specialist.
- Doctor /NS-ANP to administer.
- Monitor O2 saturation, ECG continuously and
blood gases and adjust ventilator/oxygen appropriately. Inspect Survanta for
discolouration prior to use.
- Suction prior to administration if necessary.
