Curosurf Administration

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(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


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