Surfactant Replacement Therapy Quiz
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Questions and Answers

According to the AARC Clinical Practice Guideline, when is administration of surfactant replacement therapy strongly recommended?

  • In any clinical setting with neonatal patients
  • Only when other treatment options have failed
  • In a clinical setting where properly trained personnel and equipment for intubation and resuscitation are readily available (correct)
  • Only in cases of severe respiratory distress

    • What does the AARC Clinical Practice Guideline recommend for neonatal respiratory distress syndrome (RDS) when surfactant deficiency is suspected?

  • Observation without intervention
  • Immediate intubation and mechanical ventilation
  • Use of corticosteroids
  • Prophylactic surfactant administration (correct)

    • What type of surfactant dose strategy does the AARC Clinical Practice Guideline recommend?

  • Variable dose strategy
  • Multiple surfactant dose strategy (correct)
  • No specific recommendation for dose strategy
  • Single dose strategy

    • How many clinical trials and systematic reviews were the recommendations in the AARC Clinical Practice Guideline based on?

    <p>253 clinical trials and systematic reviews, and 12 articles</p> Signup and view all the answers

    What is the primary concern about the purification of natural surfactants?

    <p>Transmission of prion diseases</p> Signup and view all the answers

    What is the effect of prophylactic and early surfactant replacement therapy within 2 hours of birth?

    <p>Reduces mortality and pulmonary complications in RDS</p> Signup and view all the answers

    What is the impact of a lower treatment threshold of FIO2 < 0.45 in surfactant replacement therapy?

    <p>Reduces incidence of air leak syndromes and BPD</p> Signup and view all the answers

    What is the association between a higher treatment threshold of FIO2 > 0.45 and surfactant replacement therapy?

    <p>Increased risk of patent ductus arteriosus</p> Signup and view all the answers

    What evidence is there regarding mean arterial pressure after surfactant administration?

    <p>22 mm Hg change in mean arterial pressure</p> Signup and view all the answers

    What is the impact of early surfactant therapy followed by planned extubation to nasal CPAP?

    <p>Reduces the incidence of BPD</p> Signup and view all the answers

    What is the association between early treatment of RDS within 2 hours of birth and long-term clinical pulmonary complications?

    <p>Associated with fewer long-term clinical pulmonary complications</p> Signup and view all the answers

    What has surfactant replacement therapy been associated with in terms of mortality and neuro-developmental disability?

    <p>Reduced mortality without increase in neuro-developmental disability</p> Signup and view all the answers

    What does the INSURE technique feature in surfactant replacement therapy?

    <p>Early surfactant replacement therapy with prompt extubation to nasal CPAP</p> Signup and view all the answers

    What is the advantage of laryngeal mask airway (LMA) administration in surfactant replacement therapy?

    <p>Requires less skill to place than traditional intubation with equivalent efficacy</p> Signup and view all the answers

    What are the cultural and religious concerns associated with surfactant preparations?

    <p>Use of bovine and/or porcine surfactant preparations</p> Signup and view all the answers

    Which surfactant is a synthetic peptide-containing surfactant approved by the FDA for neonatal RDS treatment?

    <p>Lucinactant</p> Signup and view all the answers

    Which surfactant contains a surfactant protein B (SP-B) mimicking protein called KL4?

    <p>Lucinactant</p> Signup and view all the answers

    Which type of surfactant has shown superior surface absorption and better lowering of alveolar surface tension compared to laboratory-derived synthetic surfactants?

    <p>Natural exogenous surfactants</p> Signup and view all the answers

    What is recommended for surfactant replacement therapy in terms of administration procedures and equipment?

    <p>Specific administration procedures and equipment are recommended</p> Signup and view all the answers

    What is the purpose of monitoring during surfactant replacement therapy?

    <p>To monitor various aspects including delivery device placement, FIO2, reflux of surfactant, patient position, chest-wall movement, oxygen saturation, vital signs, and pulmonary mechanics</p> Signup and view all the answers

    What is the impact of multiple doses of surfactant in infants at high risk of respiratory distress?

    <p>Greater improvements in oxygenation and decreased risk of necrotizing enterocolitis</p> Signup and view all the answers

    Which surfactant has been found to reduce surface tension to a greater extent than surfactant protein-C (SP-C)?

    <p>Lucinactant</p> Signup and view all the answers

    What is the recommended proficiency for healthcare providers administering surfactant replacement therapy?

    <p>Proficiency in technical aspects, ventilator management, patient assessment, and emergency resuscitation</p> Signup and view all the answers

    What may be given at 6-24 hour intervals in infants with ongoing respiratory insufficiency or increasing ventilator requirements?

    <p>Additional doses of surfactant</p> Signup and view all the answers

    Which surfactant is a natural exogenous surfactant?

    <p>Calfactant</p> Signup and view all the answers

    What is the impact of natural exogenous surfactants compared to laboratory-derived synthetic surfactants?

    <p>Superior surface absorption and better lowering of alveolar surface tension</p> Signup and view all the answers

    Study Notes

    Surfactant Replacement Therapy: Key Points

    • Surfactant replacement therapy improves the ratio of arterial to alveolar PO2 and the oxygen index
    • Specific administration procedures and equipment are recommended for surfactant replacement therapy, including syringes, ventilators, resuscitation equipment, and monitoring devices
    • Healthcare providers administering surfactant replacement therapy should be proficient in technical aspects, ventilator management, patient assessment, and emergency resuscitation
    • Monitoring during surfactant replacement therapy includes checking delivery device placement, FIO2, reflux of surfactant, patient position, chest-wall movement, oxygen saturation, vital signs, and pulmonary mechanics
    • Additional doses of surfactant may be given at 6-24 hour intervals in infants with ongoing respiratory insufficiency or increasing ventilator requirements
    • Lucinactant is a synthetic peptide-containing surfactant approved by the FDA for neonatal RDS treatment, with similar mortality and morbidity rates to other surfactants in clinical trials
    • Currently available surfactants include poractant alfa, calfactant, beractant, and lucinactant, each with different doses and sources
    • Lucinactant contains a surfactant protein B (SP-B) mimicking protein called KL4, which has been found to reduce surface tension to a greater extent than surfactant protein-C (SP-C)
    • Natural exogenous surfactants have shown superior surface absorption and better lowering of alveolar surface tension compared to laboratory-derived synthetic surfactants
    • Synthetic preparations may have better quality control than natural surfactants due to batch-to-batch variations in natural surfactants
    • Multiple doses of surfactant in infants at high risk of respiratory distress have resulted in greater improvements in oxygenation, decreased risk of necrotizing enterocolitis, and decreased mortality
    • The frequency of surfactant replacement therapy should depend on the clinical status of the patient and the indication for the procedure, with additional doses indicated for infants with increasing ventilator requirements or unimproved conditions after the initial dose

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    Related Documents

    Surfactant Replacement Therapy 2013 PDF

    Description

    Test your knowledge of surfactant replacement therapy with this quiz. Explore key points including administration procedures, monitoring, surfactant types, and clinical considerations for neonatal respiratory distress syndrome treatment.

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