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Questions and Answers
According to the AARC Clinical Practice Guideline, when is administration of surfactant replacement therapy strongly recommended?
What does the AARC Clinical Practice Guideline recommend for neonatal respiratory distress syndrome (RDS) when surfactant deficiency is suspected?
What type of surfactant dose strategy does the AARC Clinical Practice Guideline recommend?
How many clinical trials and systematic reviews were the recommendations in the AARC Clinical Practice Guideline based on?
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What is the primary concern about the purification of natural surfactants?
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What is the effect of prophylactic and early surfactant replacement therapy within 2 hours of birth?
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What is the impact of a lower treatment threshold of FIO2 < 0.45 in surfactant replacement therapy?
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What is the association between a higher treatment threshold of FIO2 > 0.45 and surfactant replacement therapy?
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What evidence is there regarding mean arterial pressure after surfactant administration?
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What is the impact of early surfactant therapy followed by planned extubation to nasal CPAP?
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What is the association between early treatment of RDS within 2 hours of birth and long-term clinical pulmonary complications?
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What has surfactant replacement therapy been associated with in terms of mortality and neuro-developmental disability?
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What does the INSURE technique feature in surfactant replacement therapy?
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What is the advantage of laryngeal mask airway (LMA) administration in surfactant replacement therapy?
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What are the cultural and religious concerns associated with surfactant preparations?
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Which surfactant is a synthetic peptide-containing surfactant approved by the FDA for neonatal RDS treatment?
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Which surfactant contains a surfactant protein B (SP-B) mimicking protein called KL4?
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Which type of surfactant has shown superior surface absorption and better lowering of alveolar surface tension compared to laboratory-derived synthetic surfactants?
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What is recommended for surfactant replacement therapy in terms of administration procedures and equipment?
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What is the purpose of monitoring during surfactant replacement therapy?
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What is the impact of multiple doses of surfactant in infants at high risk of respiratory distress?
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Which surfactant has been found to reduce surface tension to a greater extent than surfactant protein-C (SP-C)?
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What is the recommended proficiency for healthcare providers administering surfactant replacement therapy?
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What may be given at 6-24 hour intervals in infants with ongoing respiratory insufficiency or increasing ventilator requirements?
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Which surfactant is a natural exogenous surfactant?
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What is the impact of natural exogenous surfactants compared to laboratory-derived synthetic surfactants?
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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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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.
