Survanta dosing should be every 6-12 hours for three doses. The frequency of dosing and the total number of doses is at the discretion of the attending Neonatologist. Rapid response may mean that additional improvement would not be expected and therefore additional doses would not be required; conversely, if there is an unfavorable response to the first dose or if the patient is "too unstable" to tolerate dosing, additional doses might not be given. Therefore the attending Neonatologist should make the decision about additional doses after the initial dose.
INDICATIONS
Prophylactic use
- All infants <1000 gm birth weight or with prenatal documentation of surfactant insufficiency. Exceptions should be approved by neonatologist. Up to 3 doses of artificial surfactant are routinely administered. The first dose is given within one hour of intubation; subsequent doses at 8-12 hour intervals at the attending neonatologist's discretion. After the initial dose ask the attending what their preference is regarding dosing schedule and if additional doses are to be given.
Rescue use
- All infants not treated prophylactically with established respiratory distress syndrome are treated as "rescue". 2-4 doses of artificial surfactant are routinely administered beginning at initial diagnosis, then at 12 hour intervals.
Possible Indications for Rescue use
- Diaphragmatic hernia
- Established respiratory failure from meconium aspiration
- Established respiratory failure from pneumonia
- Atypical or intractable respiratory failure
- Adult respiratory distress syndrome in non-neonatal patients
- Intractable respiratory failure in non-neonatal patients
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