Indications for Surfactant theray
RDS in pre-term baby
Meconium aspiration syndrome and pulmonary haemorrhage (Seek consultant’s advice)
Timing of administration for SDLD
Early administration is more effective
Initial dose should be given within first 24 hours
Rescue if CPAP not adequate
RDS requiring intubation
Requirements for procedure
Surfactant (Survanta – 4ml/kg [100mg/kg])
Sterile gloves
5FG feeding tube – cut to required length with sterile blade
Experienced medical officer to administer and assistant
Procedure
Warm to room temperature
Do not shake
Calculate the dose
Ensure correct ETT position
Invert the bottle 2-3 times (without shaking to mix)
Draw up the required volume
Give it 1-2 aliquots depending on the volume
Take 20-30 minutes for the procedure and give manual breaths for a brief period
Reduce FiO₂ as required during and soon after the procedure
Do not suck the ETT for 4-6 hours
Capillary blood gas after 1 hour and adjust the setting
Assess oxygen requirement after 6-8 hours of therapy – if >30% a repeat dose is indicated stat