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.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.



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.

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References in periodicals archive ?
While nasal CPAP was continued in one group, calfactant (Infasurf) was administered by laryngeal mask and subsequently nasal CPAP was inititated in the other group.
Curosurf Poractant alpha Alveofact SF-RI 1 BLES Bovine Lipid Extract Surfactant Infasurf Calfactant CLSE Newfacten ?
In addition to colfosceril and beractant, the other two FDA-approved surfactants are poractant alpha (Curosurf) and calfactant (Infasurf).
The independent analysis, which was published in the eFirst Pages section of the Pediatrics website, was aimed at comparing the efficacy of CUROSURF versus Survanta (beractant) and Infasurf (calfactant) with respect to clinical outcomes among preterm infants with RDS.
The biological surfactant preparation Infasurf (calfactant) was a natural lung-ravage surfactant derived from calf lung that required no reconstitution.
Four large (several hundred in each group), prospective randomized clinical trials comparing Exosurf (synthetic, no apoproteins) to Survanta (beractant) and to Infasurf (calfactant) have been conducted.
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.
Last, there is nothing in the composition, biophysical properties, or biologic activity of poractant alfa compared to beractant or calfactant that can explain a mortality benefit.
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).