surf act ant therapy

8/8/2019 Surf Act Ant Therapy

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by Mahdi Al- Dahan

208026712


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topics

definitiondefinition

Function of surfactantFunction of surfactant

Types of surfactant therapyTypes of surfactant therapy

Surfactant therapySurfactant therapy


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definitionIt is a lipoprotein organic compounds having ahydrophilic "head" and a hydrophobic "tail to

reduces surface tension and permits moreefficient

gas transport

Also calledtensio-active agents/tensides


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surfacesurfacetensiontension

Function o

fsur

factant

Preventleakage

Keep alveoliopen

Maintainalveoli shape


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Appearance ofsurfactanty Formation of type II alveolar cells during 2222--26 wks26 wks

y Appearance of surfactant 30 wk30 wk

yAppearance of mature surfactant 33 wk33 wk

y Phosphotidal glesrol mature surfactant 35 wk35 wk


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Sur

factant

defici

ency


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Signs o

fRD

S

y Tachypnea

y Hypoxiay Cyanosis

y Expiratory grunting

y Subcostal and intercostal retractions

y Nasal flaring


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Typ

es o

fsur

factant th

erapy

Instillation of surfactant into the lungs

y Synthetic surfactant ( almost not in use anymore)

y Natural Surfactant (porcine, bovine)

y Prophylactic vs Rescue


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Synth

etic sur

factantSynthetic surfactant is effective in reducing respiratory

distress syndrome for babies born prematurely (before34 weeks) also it reduce the risk of pneumothorax anddeath

The side effect is the increased risk of pulmonaryhemorrhage

its feedstocks may have branched carbon chains and

contain even or odd numbers of carbon atoms.


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Natural Surfactant Oleochemical surfactants, also referred to as natural

surfactants are made from plant-derived oils such ascoconut and cottonseed palm, or from animal fatssuch as tallow, lard or fish oil.

Natural surfactants are just as effective as syntheticsurfactant cleaners but are better for theenvironment and babys health

The carbon chains of natural feedstocks are always

linear and even-numbered


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Prophylactic vs Rescue

prophylacticprophylactic rescuerescue

Infants at high risk of developing RDS Preterm infants established RDS

Primary purpose to give surfactant Primary purpose to treat RDS

Administered before respiratorysymptoms or efforts Administered at specific thresholdcriteria for respiratorydistresssyndrome

Given after initial resuscitation within10 to30 minutes after birth

Given as early rescue surfactanttreatment 1 to 2 hours of birth

and late rescue surfactant treatment 2or morehours after birth

Low risk of complication with RDS andBPD

High risk of complication with RDS andBPD


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Surfactant therapysurfactant is given by endotracheal instillation in

addition to standard therapy

16

control group16

control group 43 surfactant group43 surfactant groupPt receive 8 doseof 50 mg PhL/kg

Pt receive 8 dose of100 mg PhL/kg

Pt receive 4 doses of 100 mgphospholipids/kg

Didnt change Fio2 after 120 hrs of treatment

Mortality 43.8 % Mortality 18.8%


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surf act ant therapy

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