Prevention of respiratory distress syndrome (RDS) in premature infants at
high risk for RDS and for the treatment ("rescue") of premature infants who
Treatment: For infants less than or equal to 72 hours of age with RDS
(confirmed by clinical and radiologic findings) and requiring endotracheal
For intratracheal administration only; the administration of exogenous
surfactants often rapidly improves oxygenation and lung compliance. Transient
episodes of cyanosis, bradycardia, reflux of surfactant into the endotracheal
tube, and airway obstruction were observed more frequently among infants treated
with calfactant in clinical trials.
Cardiovascular: Bradycardia (34%), cyanosis (65%)
Respiratory: Airway obstruction (39%), reflux (21%), requirement for manual
ventilation (16%), reintubation (1% to 10%)
There have been no known reports of overdosage. While there are no known
adverse effects of excess lung surfactant, overdoses would result in overloading
the lungs with an isotonic solution. Ventilation should be supported until
clearance of the liquid is accomplished.
Gently swirling or agitation of the vial of suspension is often necessary for
redispersion. Do not shake. Visible flecks of the suspension and foaming
at the surface are normal. Calfactant should be stored at refrigeration
46°F). Warming before administration is not necessary.
Unopened and unused vials of calfactant that have been warmed to room
temperature can be returned to the refrigeration storage within 24 hours for
future use. Repeated warming to room temperature should be avoided. Each
single-use vial should be entered only once and the vial with any unused
material should be discarded after the initial entry.
Endogenous lung surfactant is essential for effective ventilation because it
modifies alveolar surface tension, thereby stabilizing the alveoli. Lung
surfactant deficiency is the cause of respiratory distress syndrome (RDS) in
premature infants and lung surfactant restores surface activity to the lungs of
No human studies of absorption, biotransformation, or excretion of calfactant
have been performed
Intratracheal administration only: Each dose is 3 mL/kg body weight
at birth; should be administered every 12 hours for a total of up to 3
Gentle swirling or agitation of the vial is often necessary for redispersion
as injection suspension settles during storage; do not shake; visible
flecks in the suspension and foaming at the surface are normal; does not require
reconstitution; do not dilute or sonicate
Following administration, patients should be carefully monitored so that
oxygen therapy and ventilatory support can be modified in response to changes in
|Mental Health: Effects
on Mental Status|
Effects on Psychiatric
|Dental Health: Local
No information available to require special precautions
Effects on Dental Treatment|
No effects or complications reported
Suspension, intratracheal: 6 mL
Bloom BT, Kattwinkel J, Hall RT, et al,
"Comparison of Infasurf® (Calf Lung Surfactant Extract) to
Survanta® (Beractant) in the Treatment and Prevention of
Respiratory Distress Syndrome," Pediatrics, 1997, 100(1):31-8.
Hudak ML, Martin DJ, Egan EA, et al,
"A Multicenter Randomized Masked Comparison Trail of Synthetic Surfactant Versus Calf Lung Surfactant Extract in the Prevention of Neonatal Respiratory Distress Syndrome,"
Pediatrics, 1997, 100(1):39-50.
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