- During an instillation of Infasurf, we couldn’t seem to get it to
stay down in the lungs. It moved up and down inside the ET tube with each breath.
Why did this happen?
- Infasurf seems to be much thicker than other surfactants we’ve used.
Why is Infasurf so thick?
- We have seen desaturations and bradycardia when we instill Infasurf.
Why?
- What is the time you’re allowed to leave Infasurf out of refrigeration
before it is considered bad?
1. During an instillation of Infasurf, we couldn’t seem to get it to stay down in
the lungs. It moved up and down inside the ET tube with each breath. Why did this
happen?
There was not enough airway pressure to move the surfactant down and out of the
ETT and larger airways. All surfactants have their established guidelines for administration
in their package inserts.
2. Infasurf seems to be much thicker than other surfactants we’ve used. Why is Infasurf
so thick?
The apparent "thickness" results from the type of microstructure Infasurf forms
in its saline suspension. Infasurf is actually less viscous than Survanta even though
Survanta®* is more dilute. DM King et al, “Bulk shear viscosities
of endogenous and exogenous lung surfactants” in the Am J Physiol Lung Cell Mol
Physiol 2002 Feb;282 (2):L277-84.
3. We have seen desaturations and bradycardia when we instill Infasurf.
Why?
Instillation of a liquid suspension requires rapid propulsion of the liquid into
the alveoli. The airway pressure needed to accomplish this step can be greater than
the actual pressure currently utilized for treatment.
4. What is the time you’re allowed to leave Infasurf out of refrigeration before
it is considered bad?
From the package insert; unopened surfactant out for a day may be returned to the
refrigerator for future use.
* Survanta is a registered trademark of Ross Products Division, Abbott Laboratories,
Columbus, Ohio.