INDICATION1
SURVANTA is indicated for prevention and treatment (“rescue”) of respiratory distress syndrome (RDS) (hyaline membrane disease) in premature infants. SURVANTA significantly reduces the incidence of RDS, mortality due to RDS and air leak complications.
Prevention: In premature infants less than 1250 g birth weight or with evidence of surfactant deficiency, give SURVANTA as soon as possible, preferably within
Rescue: To treat infants with RDS confirmed by x-ray and requiring mechanical ventilation, give SURVANTA as soon as possible, preferably by 8 hours of age.
IMPORTANT SAFETY INFORMATION1
Warnings: SURVANTA is intended for intratracheal use only.
SURVANTA can rapidly affect oxygenation and lung compliance. Therefore, its use should be restricted to a highly supervised clinical setting with immediate availability of clinicians experienced with intubation, ventilator management, and general care of premature infants. Infants receiving SURVANTA should be frequently monitored with arterial or transcutaneous measurement of systemic oxygen and carbon dioxide.
During the dosing procedure, transient episodes of bradycardia and decreased oxygen saturation have been reported. If these occur, stop the dosing procedure and initiate appropriate measures to alleviate the condition. After stabilization, resume the dosing procedure.
Precautions: Rales and moist breath sounds can occur transiently after administration. Endotracheal suctioning or other remedial action is not necessary unless
Use of SURVANTA in infants less than 600 g birth weight or greater than
Adverse Reactions: The most commonly reported adverse experiences were transient bradycardia and oxygen desaturation; both were associated with the dosing procedure.
Other reactions during the dosing procedure occurred with fewer than 1% of doses and included endotracheal tube reflux, pallor, vasoconstriction, hypotension, endotracheal tube blockage, hypertension, hypocarbia, hypercarbia, and apnea. No deaths occurred during the dosing procedure, and all reactions resolved with symptomatic treatment.
The occurrence of concurrent illnesses common in premature infants was evaluated in the controlled trials. The rates in all controlled studies are in the
| Concurrent event | SURVANTA (%) | Control (%) | P-valuea |
| Patent ductus arteriosus | 46.9 | 47.1 | 0.814 |
| Intracranial hemorrhage | 48.1 | 45.2 | 0.241 |
| Severe intracranial hemorrhage | 24.1 | 23.3 | 0.693 |
| Pulmonary air leaks | 10.9 | 24.7 | <0.001 |
| Pulmonary interstitial emphysema | 20.2 | 38.4 | <0.001 |
| Necrotizing enterocolitis | 6.1 | 5.3 | 0.427 |
| Apnea | 65.4 | 59.6 | 0.283 |
| Severe apnea | 46.1 | 42.5 | 0.114 |
| Post-treatment sepsis | 20.7 | 16.1 | 0.019 |
| Post-treatment infection | 10.2 | 9.1 | 0.345 |
| Pulmonary hemorrhage | 7.2 | 5.3 | 0.166 |
aP-value comparing groups in controlled studies.
Reference: 1. SURVANTA [package insert].
Safety Considerations1
SURVANTA is intended for intratracheal use only. SURVANTA can rapidly affect oxygenation and lung compliance. Therefore, its use should be restricted to a highly supervised clinical setting with immediate availability of clinicians experienced with intubation, ventilator management, and general care of premature infants. Infants receiving SURVANTA should be frequently monitored with arterial or transcutaneous measurement of systemic oxygen and carbon dioxide. During the dosing procedure, transient episodes of bradycardia and decreased oxygen saturation have been reported. If these occur, stop the dosing procedure and initiate appropriate measures to alleviate the condition. After stabilization, resume the dosing procedure. In controlled clinical trials, an increased probability of post-treatment nosocomial sepsis was observed in SURVANTA-treated infants, which was not associated with increased mortality among these infants.
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