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.
===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.


'''Curosurf Storage''': Store at 36-46 F. If warmed and not opened or used, may be returned to refrigerated storage one time.
===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.


'''Preparation of Curosurf'''
===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. Warm to room temperature and gently invert (do not shake). <br/ >
===Post Curosurf Administration===
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/ >
*Remember to dial down Neopuff pressures as lung compliance improves.  
3. Draw up the total dose of curosurf that will be administered into a 5ml syringe using a 20 guage or larger needle.<br/ >
4. Attach a 5F multi access catheter (or MAC adapter).


'''Preparation of patient'''
===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. Intubate patient and verify good ETT placement.<br/ >
===Curosurf for Medevacs===
2. Make sure the ETT is well secured.
*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


'''Administration of Curosurf'''
===References===
*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]


1. Disconnect bag or ventilator.<br/ >
 
2. Instill one half of the total dose via into the ETT while patient is lying on side with one side dependant.<br/ >
[[Emergency Stabilization Information]]
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/ >
<br/>[[Pediatric Village Delivery Orientation]]
4. When patient is stable, reposition infant so the other side is dependant and repeat step #2.<br/ >
<br/>[[:Category:OB & Newborn|OB & Newborn Main Page]]
5. Remove catheter and resume ventilation. Do not suction for one hour after administration unless required for obstruction.

Latest revision as of 11:18, 26 January 2024

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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