INSURE: Selective Surfactant Following nCPAP Failure

Please see full ISI below, at the end of the above video, and on the website: curosurf.com/
Dana Evans, Respitory Care Manager at Mercy Children's Hospital in St. Louis, Missouri, discusses RDS along with AAP guidelines and recommendations. She goes on to discuss the INSURE strategy (intubation, surfactant, rapid extubation) in great detail including treatment considerations and options, as well as clinical data.
Early rescue INSURE strategy may help avoid potential for respiratory insufficiency and the need for subsequent mechanical ventilation (MV).
(Stevens TP, Blennow M, Meyers EH, et al. 2007)
It is important to note that the INSURE strategy may not be appropriate for all infants. Infants with RDS may vary markedly in the severity of respiratory disease, maturity, and presence of other complications, and thus it is neces­sary to individualize patient care.
CPAP=continuous positive airway pressure; nCPAP=nasal continuous positive airway pressure; RDS=respiratory distress syndrome.
IMPORTANT SAFETY INFORMATION
CUROSURF® (poractant alfa) is intended for intratracheal use only. The administration of exogenous surfactants, including CUROSURF, can rapidly affect oxygenation and lung compliance. Therefore, infants receiving CUROSURF should receive frequent clinical and laboratory assessments so that oxygen and ventilatory support can be modified to respond to respiratory changes.
CUROSURF should only be administered by those trained and experienced in the care, resuscitation, and stabilization of preterm infants.
Transient adverse reactions associated with administration of CUROSURF include bradycardia, hypotension, endotracheal tube blockage, and oxygen desaturation. These events require stopping CUROSURF administration and taking appropriate measures to alleviate the condition. After the patient is stable, dosing may proceed with appropriate monitoring.
Pulmonary hemorrhage, a known complication of premature birth and very low birth-weight, has been reported with CUROSURF. The rates of common complications of prematurity observed in a multicenter single-dose study that enrolled infants 700-2000 g birth weight with RDS requiring mechanical ventilation and FiO2 greater than or equal to 0.60 are as follows for CUROSURF 2.5 mL/kg (200 mg/kg) (n=78) and control (n=66; no surfactant) respectively: acquired pneumonia (17% vs. 21%), acquired septicemia (14% vs. 18%), bronchopulmonary dysplasia (18% vs. 22%), intracranial hemorrhage (51% vs. 64%), patent ductus arteriosus (60% vs. 48%), pneumothorax (21% vs. 36%) and pulmonary interstitial emphysema (21% vs. 38%).
INDICATION
CUROSURF® (poractant alfa) Intratracheal Suspension is indicated for the rescue treatment of Respiratory Distress Syndrome (RDS) in premature infants. CUROSURF reduces mortality and pneumothoraces associated with RDS.
Please see full prescribing information: resources.chie...
This site is intended for United States residents only.
CUROSURF® is a registered trademark of Chiesi Farmaceutici, S.p.A.
PP-C-0632 V1.0