Surfactant therapy is the medical administration of exogenous
surfactant
Surfactants are chemical compounds that decrease the surface tension between two liquids, between a gas and a liquid, or interfacial tension between a liquid and a solid. Surfactants may act as detergents, wetting agents, emulsifiers, foaming ...
. Surfactants used in this manner are typically instilled directly into the
trachea
The trachea, also known as the windpipe, is a Cartilage, cartilaginous tube that connects the larynx to the bronchi of the lungs, allowing the passage of air, and so is present in almost all air-breathing animals with lungs. The trachea extends ...
. When a baby comes out of the womb and the lungs are not developed yet, they require administration of surfactant in order to process oxygen and survive. This condition that the baby has is called newborn respiratory distress syndrome, and it is treatable. Surfactant coat the smallest parts of the lungs called the alveoli and helps for oxygen to go in and for carbon dioxide to go out. How surfactant does this is by not allowing the alveoli to collapse and to retain their inflated shape when the baby exhales.
In premature babies the type II
pneumocytes
A pulmonary alveolus (plural: alveoli, from Latin ''alveolus'', "little cavity"), also known as an air sac or air space, is one of millions of hollow, distensible cup-shaped cavities in the lungs where oxygen is exchanged for carbon dioxide. Al ...
, special lung cells that make surfactant, are not working yet. This means that the baby needs to get surfactant until that baby can make the surfactant on his own. In addition, the baby will need to be monitored and checked regularly as well as intubated or put on CPAP so that he can breathe. This means that until he is able to make surfactant and breathe on his own, he needs to be watched carefully by doctors and nurses.
Types of surfactants
Poractant alfa
Poractant alfa is a pulmonary surfactant sold under the brand name Curosurf by Chiesi Farmaceutici. Poractant alfa is an extract of natural porcine lung surfactant. As with other surfactants, marked improvement on oxygenation may occur within mi ...
,
Calfactant
Calfactant, also known as Infasurf, is an intratracheal suspension derived from the natural surfactant in calf lungs. It is used in premature infants with lung surfactant deficiency that causes infant respiratory distress syndrome
Infantile ...
, and
Beractant
Beractant, also known by the trade name of Survanta, is a modified bovine pulmonary surfactant containing bovine lung extract (phospholipids, neutral lipids,
fatty acids, and bovine surfactant proteins), to which synthetic DPPC, tripalmitin and p ...
are types of natural surfactants commercially available in the
United States
The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territorie ...
. Although data is sometimes conflicting, it appears that there are no significant differences among the available preparations.
LISA surfactant delivery in infants
The LISA (Less Invasive Surfactant Administration) method is much more effective in situations where the preterm infant is already breathing, and it has become a standard procedure in German hospitals. Intubation via mechanical ventilation is less effective than the LISA method within the first 72 hours of birth.
Respiratory distress syndrome
Exogenous surfactant replacement therapy is effective in reducing
IRDS mortality and morbidity in preterm infants.
Adult respiratory distress syndrome
Surfactant therapy is not used to treat adults with
adult respiratory distress syndrome
Acute respiratory distress syndrome (ARDS) is a type of respiratory failure characterized by rapid onset of widespread inflammation in the lungs. Symptoms include shortness of breath (dyspnea), rapid breathing (tachypnea), and bluish skin color ...
because the evidence regarding its effect on patient-important outcomes is inconsistent.
See also
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Respiratory care
A respiratory therapist is a specialized healthcare practitioner trained in critical care and cardio-pulmonary medicine in order to work therapeutically with people who have acute critical conditions, cardiac and pulmonary disease. Respirator ...
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Nursing
Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health ...
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Neonatology
Neonatology is a subspecialty of pediatrics that consists of the medical care of newborn infants, especially the ill or premature newborn. It is a hospital-based specialty, and is usually practised in neonatal intensive care units (NICUs). The ...
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Meconium aspiration syndrome
Meconium aspiration syndrome (MAS) also known as neonatal aspiration of meconium is a medical condition affecting newborn infants. It describes the spectrum of disorders and pathophysiology of newborns born in meconium-stained amniotic fluid (MSAF ...
References
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Respiratory therapy
Neonatology