beractant (Survanta)

Introduction

Tradename: Survanta.

Indications

• prevention & treatment of respiratory distress syndrome (RDS) in premature infants
• prophylactic therapy: low birth weight (< 1250 g) infants
• treatment of pulmonary aspiration

Dosage

• intratracheal administration only
• instillation through a 5-French end-hole catheter inserted into the infants endotracheal tube
• administer does in 4 25 mg (1 mL)/kg aliquots
• each aliquot is administered over 2-3 seconds with the infant in a different position
• prophylaxis:
  • 100 mg (4 mL)/kg within 15 minutes of birth
  • as many as 4 doses in 1st 48 hours of life
  • doses at least 6 hours apart

Storage

• refrigerate
• protect from light
• warm prior to administration
  • 20 minutes at room temperature
  • 8 minutes hand held
  • do NOT use artificial warming methods
• may return warmed, unopened vial within 8 hours to refrigerated storage once
• do NOT shake
• swirl gently is settling occurs during storage

Suspension: phospholipids 25 mg/mL suspended in normal saline (8 mL)

Pharmacokinetics

• elimination: lung

Adverse effects

• common (> 10%)
  • transient bradycardia
• less common (1-10%)
  • oxygen desaturation
• uncommon (< 1%)
  • vasoconstriction, hypotension, hypertension, pallor, endotracheal tube blockage, hypocarbia, apnea, pulmonary air leaks, pulmonary interstitial emphysema, nosocomial sepsis

More general terms

• pulmonary agent