Patient selection: premature infants weighing from 600 to 2,000 grams (>= 23 weeks gestation)
Usage:
(1) preventive administration immediately after delivery
(2) repeated dosing in infants with radiographic or clinical evidence of the respiratory distress syndrome
phospholipid concentration of Survanta =
= 25 mg/mL
dose of Survanta =
= 100 mg per kg birth weight
Handling instructions:
(1) The solution should not be used if it is discolored (normally off white to light brown).
(2) Single use vials should not be used more than once.
(3) The drug is stored at 2-8°C.
(4) The drug should be allowed to come to room temperature before use. This can be done by either letting it sit for 20 minutes or by warming it in the hands. Other forms of warming should not be used.
(5) If unopened and unused, a vial warmed to room temperature can be returned to the refrigerator storage if done so within 24 hours of warming. A vial should not be warmed then refrigerated more than once.
4 doses can be administered within the first 48 hours after birth, with minimum interval 6 hours.
Each dose is divided into 4 quarter doses that are administered with the infant in different positions to ensure maximum distribution throughout the lung.
(1) head and body at a 5 to 10 degree decline, with head turned to the right
(2) head and body at a 5 to 10 degree decline, with head turned to the left
(3) head and body at a 5 to 10 degree incline, with head turned to the right
(4) head and body at a 5 to 10 degree incline, with head turned to the left
Administration:
(1) The dose is aspirated into a syringe.
(2) Make sure that the endotracheal tube is properly placed.
(3) Suction the endotracheal tube to make sure clear of excess secretions.
(4) Pass a soft catheter (5 French) long enough to extend just beyond the end of the endotracheal tube.
(5) Inject the quarter dose through the catheter.
(6) Remove the catheter and ventilate the infant.
(7) Proceed as above with the remaining 3 doses.
