Analysis of Surfactant Use in the Treatment of Respiratory Distress Syndrome (RDS) in a Neonatal Intensive Care Unit

Analysis of Surfactant Use in the Treatment of Respiratory Distress Syndrome (RDS) in a Neonatal Intensive Care Unit Rick Piatek, PharmD candidate; Dennis Gardner, PharmD and project preceptor Background: Respiratory distress syndrome (RDS) is a leading cause of mortality in preterm infants. Treatment involves the use of surfactant and oxygen supplementation during what is often a lengthy inpatient visit in the neonatal intensive care unit (NICU). Currently Survanta (beractant) is used in the Community Health Network as the formulary surfactant agent. The newer agent Curosurf (poractant alfa) has recently been brought under consideration as a replacement for Survanta as the formulary agent in the treatment of RDS. Objective: This study evaluates current surfactant use at Community Hospital North (CHN) and provides a cost analysis. These data will be used to compare with similar outcome data and cost obtained from a Curosurf Experience Program trial that is being considered for CHN. Methods: Retrospective review of available patient charts screening for the use of Survanta in the NICU at CHN provided an eligible study population of over 90 patients during the period of one year from 1 January 2013 to 31 December 2013. The charts for these patients and their associated hospital admission were evaluated on several different parameters. Data recorded pertaining directly to surfactant administration included absolute amount of surfactant used, average dose, number of doses needed, and calculated cost for each patient. Additionally, clinical outcomes and factors such as mortality, time to first dose, supplemental oxygen requirements, peripheral capillary oxygen saturation, and transcutaneous carbon dioxide measurements were recorded when documented. Lastly, demographic data were collected, including gestational age at birth, sex, and birth weight, to observe any correlations and elucidate any possible positive or negative predictors of patient outcomes. Significance: Ultimately this study will help in determining whether converting to Curosurf is superior to continuing use of Survanta; this study will substantiate or refute the superiority of one agent over the other through cost analysis and comparison of measured clinical outcome parameters