Physiologic Responses to Exogenous Surfactant: Nursing Interventions

Exogenous surfactant is widely used in the treatment of respiratory distress syndrome (RDS) in premature infants. However, there has not been a decrease in the incidence of intraventricular hemorrhage (IVH) in surfactant treated infants despite the decrease in the severity in RDS. Alterations in mean arterial pressure (WA), intracranial pressure (ICP), oxygen saturation (SaO2), transcutaneous C02 tension (TcCO2), and infant position have been implicated as contributing factors in the development of IVH. The surfactants currently used differ in composition and recommended method of administration. Exosurf is administered through a sideport adaptor with two changes in infant position. Using 4 changes in infant position, Survanta is administered either with a feeding tube placed through the endotracheal tube or via a multi-lumen endotracheal tube. This study was undertaken to investigate the differences in physiologic responses of the neonate during surfactant delivery suing different preparations and modes of administration. Infants were stratified by gestational age and randomly assigned to I of 3 groups: 1) Exosurf via sideport adaptor, 2) Survanta via feeding tube and 3) Survanta via multi-lumen endotracheal tube. Heart rate (HR), SaO2, TcCO2, MAP, and ICP were continuously recorded from prior to administration of surfactant to two hours following administration. Seventeen infants