Jump to content


Want to join the discussions?

Sign up for a free membership! 

If you are a member already, log in!

(lost your password? reset it here)

99nicu.org 99nicu.org

Repeat surfactant in preemies with RDS, is there a role for this practice in today's neonatology?


Recommended Posts

I would love to hear your local practice in regards to repeated doses of surfactant in neonates with respiratory distress?

The study publish by Soll in cochrane showed benefits of multiple vs single dose, but the RCT were done in the 90's when gentle ventilation and antenatal steroids were not standard in the NICU!

What do Neos across the world do in this regard?

If you do repeat the treatment, what is your criteria? GA, time after birth, degree of respiratory distress or respiratory modality?

Thanks for you feedback on this interesting topic. I am a neo neo trained in the post surfactant era, support trial and nCPAP to treat very small preemies with RDS, so is not hard for me to incorporate these new modalities in our practice!

If you do not use repeated doses of surf, can you provide any reference that support this practice?


  • Upvote 1
Link to comment
Share on other sites

Interesting question.

I work in a level-2 unit now where we do INSURE procedures, and it is rare that infants need more respiratory support than cpap after the first dose of surfactant, given that "our" babies are born from 28 weeks.

I believe though that the level-3-units @ Karolinska sometimes give 2 doses of surfactant, at least we read this in the records in some babies transferred to us for level-2-care. And I guess they use the same approach as when I was there, i.e. a 2nd dose can be given in more severe RDS when FiO2 and ventilatory settings "backlash" after the first dose AND x-ray still indicate RDS (and not other kind of lung disease).


In other words, I believe they do not have clear-cut guidelines in terms of gestational age etc, but tailor a 2 course of surfactant therapy in each individual case.

Link to comment
Share on other sites

  • 2 weeks later...
  • 2 months later...
  • 2 weeks later...

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
  • Create New...