calfactant

calfactant /cal·fac·tant/ (kal-fak´tant) a pulmonary surfactant from calf lung, used in the prophylaxis and treatment of neonatal respiratory distress syndrome.

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calfactant,

a natural lung surfactant extract.

indications It is used in the prevention and treatment (rescue) of respiratory distress syndrome in premature infants.

contraindications No contraindications are known at present.

adverse effects Concurrent illnesses that have occurred during treatment with this drug include pulmonary air leaks, pulmonary interstitial emphysema, apnea, pulmonary hemorrhage, patent ductus arteriosus, intracranial hemorrhage, severe intracranial hemorrhage, necrotizing enterocolitis, posttreatment sepsis, and posttreatment infection. Other serious adverse effects include bradycardia, oxygen desaturation, vasoconstriction, hypotension, and hypertension.

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calfactant

Infasurf

Pharmacologic class: Natural lung surfactant

Therapeutic class: Lung surfactant

Pregnancy risk category NR

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.

Route	Onset	Peak	Duration
Intratrach.	Rapid	Unknown	Unknown

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.