NICU Procedures- Surfactant administration in a preterm infant

Summary

This educational video script outlines the learning objectives for surfactant therapy, including indications and administration techniques. It covers the importance of surfactant replacement in treating respiratory distress in pre-term infants and the process of administering exogenous surfactant via the endotracheal route. The script provides a step-by-step guide on preparing equipment, inserting a catheter, and delivering surfactant while ensuring patient stability and safety. It also emphasizes the need for trained personnel and adherence to institutional guidelines.

Takeaways

• 📚 The module aims to educate on the indications for surfactant therapy and how to administer exogenous surfactant replacement therapy.
• 👶 Surfactant deficiency can lead to respiratory distress or failure in pre-term, late pre-term, or term infants.
• 💊 Indications for surfactant replacement therapy include surfactant deficiency in pre-term infants with respiratory distress syndrome and surfactant inactivation in infants with meconium aspiration syndrome.
• 🚑 Surfactant therapy can be administered prophylactically or as a rescue treatment and is delivered via the endotracheal route.
• 🏥 Proper placement and patency of the endotracheal tube are crucial before administration of surfactant.
• ⚠️ Transient adverse effects of surfactant administration may include bradycardia, oxygen desaturation, and hypotension.
• 👩‍⚕️ Surfactant should only be administered by those trained and experienced in neonatal resuscitation and stabilization.
• 🔧 The script reviews equipment used for surfactant replacement therapy and demonstrates a technique to deliver surfactant to an intubated mannequin.
• 🌐 The demonstration includes using a catheter kit with a five French catheter and adapters for different ET tube sizes.
• 🔄 The process involves disconnecting the bag, replacing the adapter, inserting the catheter, administering the surfactant, and then removing the catheter while ensuring the patient's stability.
• 🔄 The surfactant is administered in two aliquots, with the baby positioned on their right and left sides, and vital signs are monitored throughout the procedure.

Q & A

What are the learning objectives of the module discussed in the transcript?

The learning objectives of the module are to understand the indications for surfactant therapy and to learn how to provide exogenous surfactant replacement therapy.

What conditions can result from surfactant deficiency in infants?

Surfactant deficiency may result in respiratory distress or respiratory failure in pre-term, late preterm, or term infants.

Which infants are indicated for exogenous surfactant replacement therapy?

Indications for exogenous surfactant replacement therapy include pre-term infants with respiratory distress syndrome and infants with conditions like meconium aspiration syndrome where surfactant is inactivated.

Can surfactant be given as a preventive measure or only when needed?

Surfactant may be given as either prophylactic (preventive) or as rescue treatment.

What are some potential adverse effects of surfactant administration?

Transient adverse effects of surfactant administration may include bradycardia, oxygen desaturation, and hypotension.

Who should administer surfactant therapy?

Surfactant therapy should only be administered by those who are trained and experienced in the care, resuscitation, and stabilization of neonates.

What equipment is necessary for surfactant replacement therapy as described in the transcript?

The necessary equipment includes a catheter kit with a five French catheter and different size adapters for the appropriate size endotracheal (ET) tube.

How is the surfactant adapter connected to the ET tube?

The stock adapter from the ET tube is removed, and the appropriate size surfactant adapter from the kit is placed where the original adapter was.

What is the procedure for administering surfactant to an intubated patient?

The procedure involves inserting the catheter to the proper placement, administering the surfactant, and then removing the catheter while ensuring the patient's stability throughout the process.

How should the catheter be inserted into the ET tube for proper surfactant administration?

The catheter should be inserted matching the markings on the endotracheal tube to the proper markings on the catheter, and then advanced about half a centimeter beyond that.

What is the recommended time to wait after administering surfactant before suctioning the patient?

It is recommended to wait a minimum of 1 hour after the administration of surfactant before suctioning the patient.