a pulmonary surfactant from calf lung, used in the prophylaxis and treatment of neonatal respiratory distress syndrome; administered intratracheally by instillation via the endotracheal tube.



Pharmacologic class: Natural lung surfactant

Therapeutic class: Lung surfactant

Pregnancy risk category NR


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


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.




Use cautiously in:
• altered ventilation requirements
• risk of cyanosis, bradycardia, or airway obstruction.


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


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.


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


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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References in periodicals archive ?
At the Academic Pediatric Society meetings in 2007 in Toronto, a retrospective, epidemiologic paper was presented that reported that Curosurf patients experienced a lower all cause in-hospital mortality than beractant or calfactant patients.
Thus, US neonatologists who wish to use poractant alfa prophylactically have to use it "off label" when there are already 2 lung surfactants, beractant and calfactant, approved for prophylactic use.
Tokyo, Japan, Jan 15, 2008 - (JCN) - Kissei Pharmaceutical today announced that it entered an agreement with New York-based Pneuma Partners LLC concerning research, development and marketing for Calfactant in Japan.
Kissei will attempt to get an early approval of Calfactant for the indication of Acute Lung Injury (ALI) and Acute Respiratory Distress Syndrome (ARDS) utilizing the results of phase III clinical trial which will be conducted by Pneuma in the US.
Calfactant is another modified natural surfactant preparation from calf lung (bovine).
For both groups, death rates were nearly 20% lower for babies treated with poractant alfa than for those treated with either beractant or calfactant.