Calfactant = Infasurf

INDICATIONS AND USE: Prevention and treatment of neonatal respiratory distress syndrome (RDS).

ACTIONS: Natural, preservative-free calf lung extract that contains phospholipids, neutral lipids, fatty acids, and

surfactant-associated proteins B and C. Each milliliter of calfactant contains 35 mg of total phospholipids and

0.65 mg of proteins (0.26 mg of protein B). Calfactant decreases the surface tension on alveolar surfaces, stabilizing

the alveoli and preventing collapse. This results in improved ventilation, lung compliance, and gas exchange.

DOSAGE: ETT.

• Prophylactic initial dose for RDS: As soon as possible after birth, give 3 mL/kg/dose, divided into two

1.5–mL/kg aliquots. After the instillation of each aliquot, position infant either on the right or left side.

Ventilation is continued during administration over 20–30 seconds. The 2 aliquots should be separated by a

pause to evaluate respiratory status and reposition the patient.

• The initial dose may be followed by 3 subsequent doses of 3 mL/kg/dose at 12-hour intervals, if necessary.

ADVERSE EFFECTS: Bradycardia, cyanosis, airway obstruction, pneumothorax, pulmonary hemorrhage, and

apnea. Most adverse effects occur during administration of dose.

COMMENTS: Following administration, lung compliance and oxygenation often rapidly improve. Patients should

be closely monitored and appropriate changes in ventilatory support should be made as clinically indicated.