calfactant

Action

Adsorbs rapidly to air: liquid interface of lung alveoli, stabilizing and modifying surface tension. Restores adequate pressure volumes, gas exchange, and overall lung compliance.

Availability

Suspension for intratracheal injection: 6 ml in single-dose vials

Indications and dosages

➣ To prevent respiratory distress syndrome (RDS) in at-risk premature infants; treatment of infants who develop RDS

Premature infants: 3 ml/kg at birth intratracheally q 12 hours, up to three doses. Initial dose must be administered as two 1.5-ml/kg doses.

Contraindications

None

Precautions

Use cautiously in:

• altered ventilation requirements

• risk of cyanosis, bradycardia, or airway obstruction.

Administration

☞ Know that drug is intended for intratracheal administration and should be given only by neonatologists or other clinicians experienced in neonatal intubation and ventilatory management in facilities with adequate personnel, equipment, and drugs.

☞ Don't dilute drug or shake vial.

• Be aware that drug must be drawn into syringe through 20G or larger needle, taking care to avoid excessive foaming. Needle must be removed before drug is delivered through endotracheal tube.

☞ Know that infant must receive continuous monitoring before, during, and after drug administration.

Adverse reactions

CV: bradycardia

Respiratory: requirement for manual ventilation or reintubation, airway obstruction, reflux of drug into endotracheal tube, cyanosis

Interactions

None significant

Patient monitoring

☞ Monitor infant's respiratory status continuously during and after drug administration.

Patient teaching

• Teach parents about treatment and assure them that infant will be monitored carefully.