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(last updated 7/16/2019)
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.
- 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
- Nouraeyan N, Lambrinakos-Raymond A, Leone M, Sant'Anna G. Surfactant administration in neonates: A review of delivery methods. Can J Respir Ther. 2014;50(3):91-95.
- Polin et al. 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
- Y catheter use YouTube video
Emergency Stabilization Information
Pediatric Village Delivery Orientation
OB & Newborn Main Page