Anemia of Prematurity - Portal Neonatal

*DPPC indicates dipalmitoyl phosphatidyl choline; PG, phosphatidylglycerol; SP-B and SP-C,
surfactant proteins B and C; bLES, bovine lipid extract surfactant; ALEC, artificial lung expanding
compound.
Consultations: Premature infants with RDS are prone to various complications. Appropriate
consultations may be obtained as indicated.
Diet: See fluids, metabolism, and nutrition in the Medical Care section.
MEDICATION Section 7 of 11
The goals of pharmacotherapy are to reduce morbidity and prevent complications.
Drug Category: Lung surfactants -- Exogenous surfactant can be helpful in treatment of airspace
disease (eg, RDS). Following inhaled administration, surface tension is reduced and alveoli are
stabilized, thus decreasing the work of breathing and increasing lung compliance.
Beractant (Survanta, Alveofact) -- Natural bovine lung extract that
lowers surface tension on alveolar surfaces during respiration and
Drug Name stabilizes alveoli against collapse at resting transpulmonary pressures.
For ET use only.
ET: 4 mL/kg (100 mg/kg) divided in 4 aliquots administered at least 6 h
Pediatric Dose
apart for 1-4 doses
Contraindications Documented hypersensitivity
Interactions None reported
Pregnancy C - Safety for use during pregnancy has not been established.
Must be warmed to room temperature; administer only under carefully
supervised conditions because of risk of acute airway obstruction
Precautions
Marked improvement in oxygenation may occur after administration,
hence, decrease oxygen and ventilator pressures (expired tidal
volume) as suggested by blood gases; monitor systemic oxygenation
to avoid hyperoxia or hypoxia; surfactant may reflux into ET tube
(hence, administer it rapidly followed by positive pressure ventilation);
monitor heart rate and blood pressure; because ET may rarely become
occluded, suction infant's ET tube (preferably using closed suction
system) prior to administering surfactant; pulmonary hemorrhage may
occur in extremely premature infants (exclude PDA); apnea and
nosocomial sepsis may also occur
Calfactant (Infasurf) -- A natural calf lung extract containing
Drug Name phospholipids, fatty acids, and surfactant-associated proteins B (260
mcg/mL) and C (390 mcg/mL). For ET use only.
Pediatric Dose ET: 3 mL/kg (105 mg/kg) q6-12h for 1-4 doses
Contraindications Documented hypersensitivity
Interactions None reported
Pregnancy C - Safety for use during pregnancy has not been established.
Precautions Administer only under carefully supervised conditions, because of risk