INSURE: Treating Infants Following NIV Failure: CUROSURF® (poractant alfa)

Please see full ISI below, at the end of the above video, and on the website: curosurf.com/
The INSURE strategy (intubation, surfactant, rapid extubation) is strongly recommended by the AAP This video discusses the INSURE technique in great detail, specifically with the use of CUROSURF after noninvasive ventilation failure. It also provides step-by-step instructions for dosing and administering CUROSURF. Using CPAP immediately after birth with subsequent selective surfactant administration may be considered as an alternative to routine intubation with prophylactic or early surfactant administration in preterm infants (Level of Evidence: 1, Strong Recommendation). This is a statement that is being referenced (1-2). If it is likely that respiratory support with a ventilator will be needed, early administration of surfactant followed by rapid extubation is preferable to prolonged ventilation (Level of Evidence: 1, Strong Recommendation). This is a statement that is being referenced (1-2).
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.
CUROSURF (poractant alfa), is an intratracheal suspension indicated for the rescue treatment of Respiratory Distress Syndrome (RDS) in premature infants.
AAP=American Academy of Pediatrics; CPAP=continuous positive airway pressure.
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.
REFERENCES : 1 . Polin RA, Carlo WA; Committee on Fetus and Newborn; American Academy of Pediatrics. Pediatrics . 2014;133:1 56-163. 2 . Committee on Fetus and Newborn, American Academy of Pediatrics. Pediatrics . 2014;133(1):171-174.
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-0626 V1.0