Curosurf Administration: Difference between revisions

From Guide to YKHC Medical Practices

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Give only to < 30 wk premies, infants with X-ray proven RDS or in consultation with a NICU consultant.
(last updated 7/16/2019)


'''Curosurf Storage''': Store at 36-46 F. If warmed and not opened or used, may be returned to refrigerated storage one time.
===Curosurf Indications===
Give Curosurf <26 wks '''OR''' 26–29 wks and needs ≥ 40% O2 '''OR''' > 29 wks with CXR proven RDS


'''Preparation of Curosurf'''
===Preparation of Curosurf===
*Warm to room temperature and gently invert (do not shake).
*Draw up Curosurf dose from the [[media:Neonatal resuscitation summary.pdf|Neonatal Resuscitation Summary]] using estimated gestational age OR if weight is known, calculate Curosurf dose using 2.5 mL/kg
*Draw up total Curosurf dose using a 20 gauge or larger needle. Divide the dose between two syringes with half the dose in each.


1. Warm to room temperature and gently invert (do not shake). <br/ >
===Preparation of patient===
2. Determine Curosurf dose for estimated gestational age on the neonatal summary resuscitation sheet or, if weight is known, calculate Curosurf dose using 2.5 mls/kg.<br/ >
*Prior to intubation (if possible) remove the stock ETT cap and replace it to make sure it comes on and off easily after you intubate the infant. Choose correct Y cap and check fit on ETT.
3. Draw up the total dose of curosurf that will be administered into a 5ml syringe using a 20 guage or larger needle.<br/ >
*Intubate patient with ETT cap on tube. Verify good ETT placement
4. Attach a 5F multi access catheter (or MAC adapter).
*Make sure the ETT is well secured.


'''Preparation of patient'''
===Administration of Curosurf===
*Disconnect Neopuff, bag, or ventilator.
*Remove ETT cap (cut it if it is too stuck) and attach Y catheter to port.
*Insert catheter until numbers on catheter match the numbers on the ETT and then advance ½ cm further. If you are unable to see the numbers, look for the color that matches the desired depth.
*Turn the patient on his/her side. Instill half the dose, while bagging continuously
*Remove catheter and bag baby at a rate of 40-60 breaths/min for one minute.
*When patient is stable, reposition infant so the other side is dependent and administer the other half of dose.
*Place infant in supine position. Remove Y catheter and adapter, replace ETT cap and resume ventilation. Do not suction for one hour after administration unless required for obstruction.


1. Intubate patient and verify good ETT placement.<br/ >
===Post Curosurf Administration===
2. Make sure the ETT is well secured.
*Remember to dial down Neopuff pressures as lung compliance improves.  


'''Administration of Curosurf'''
===Curosurf Storage===
*Stored at 36-46 F in OB medication refrigerator. If warmed and not opened or used, may be returned to refrigerated storage one time.


1. Disconnect bag or ventilator.<br/ >
===Curosurf for Medevacs===
2. Instill one half of the total dose via into the ETT while patient is lying on side with one side dependant.<br/ >
*Curosurf is stored in the OB refrigerator. Put Curosurf into pink bag next to it. Pink bag has a copy of the Curosurf protocol and Village Delivery Orientation in the front pouch for reference. Curosurf Y catheter is stocked in the inside net pouch of the OB bag
3. Remove catheter and bag baby with 100% O2 (or less…may not require 100% if blender is available) at a rate of 40-60 breaths/min for one minute.<br/ >
 
4. When patient is stable, reposition infant so the other side is dependant and repeat step #2.<br/ >
===References===
5. Remove catheter and resume ventilation. Do not suction for one hour after administration unless required for obstruction.
*Nouraeyan N, Lambrinakos-Raymond A, Leone M, Sant'Anna G. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4456838/ Surfactant administration in neonates: A review of delivery methods]. ''Can J Respir Ther''. 2014;50(3):91-95.
*Polin et al.  [https://pediatrics.aappublications.org/content/133/1/156 Surfactant Replacement Therapy for Preterm and Term Neonates With Respiratory Distress]. ''Pediatrics'' January 2014, 133 (1) 156-163; DOI: doi.org/10.1542/peds.2013-3443
*[https://www.youtube.com/watch?v=1tic3rMVBMs Y catheter use YouTube video]
 
 
[[Emergency Stabilization Information]]
<br/>[[Pediatric Village Delivery Orientation]]
<br/>[[:Category:OB & Newborn|OB & Newborn Main Page]]

Revision as of 09:44, 5 December 2020

(last updated 7/16/2019)

Curosurf Indications

Give Curosurf <26 wks OR 26–29 wks and needs ≥ 40% O2 OR > 29 wks with CXR proven RDS

Preparation of Curosurf

  • Warm to room temperature and gently invert (do not shake).
  • Draw up Curosurf dose from the Neonatal Resuscitation Summary using estimated gestational age OR if weight is known, calculate Curosurf dose using 2.5 mL/kg
  • Draw up total Curosurf dose using a 20 gauge or larger needle. Divide the dose between two syringes with half the dose in each.

Preparation of patient

  • Prior to intubation (if possible) remove the stock ETT cap and replace it to make sure it comes on and off easily after you intubate the infant. Choose correct Y cap and check fit on ETT.
  • Intubate patient with ETT cap on tube. Verify good ETT placement
  • Make sure the ETT is well secured.

Administration of Curosurf

  • Disconnect Neopuff, bag, or ventilator.
  • Remove ETT cap (cut it if it is too stuck) and attach Y catheter to port.
  • Insert catheter until numbers on catheter match the numbers on the ETT and then advance ½ cm further. If you are unable to see the numbers, look for the color that matches the desired depth.
  • Turn the patient on his/her side. Instill half the dose, while bagging continuously
  • Remove catheter and bag baby at a rate of 40-60 breaths/min for one minute.
  • When patient is stable, reposition infant so the other side is dependent and administer the other half of dose.
  • Place infant in supine position. Remove Y catheter and adapter, replace ETT cap and resume ventilation. Do not suction for one hour after administration unless required for obstruction.

Post Curosurf Administration

  • Remember to dial down Neopuff pressures as lung compliance improves.

Curosurf Storage

  • Stored at 36-46 F in OB medication refrigerator. If warmed and not opened or used, may be returned to refrigerated storage one time.

Curosurf for Medevacs

  • Curosurf is stored in the OB refrigerator. Put Curosurf into pink bag next to it. Pink bag has a copy of the Curosurf protocol and Village Delivery Orientation in the front pouch for reference. Curosurf Y catheter is stocked in the inside net pouch of the OB bag

References


Emergency Stabilization Information
Pediatric Village Delivery Orientation
OB & Newborn Main Page

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