Calfactant

Infasurf

surfactantintratrachealOnset: MinutesDuration: Variable

Mechanism of Action

Natural bovine lung surfactant extract. Contains phospholipids and surfactant proteins SP-B and SP-C. Reduces alveolar surface tension to near-zero during expiration, preventing end-expiratory alveolar collapse.

Dosing

Neonatal

3 mL/kg intratracheally (105 mg phospholipids/kg). May repeat q12h × 3 doses

Indications

Prevention and treatment of RDS in premature neonates

Contraindications

None absolute in RDS setting

Side Effects

Bradycardia during instillation
O2 desaturation
ETT reflux
Airway obstruction

Monitoring Parameters

SpO2 and heart rate continuously
Ventilator compliance changes
Blood gas post-administration

Drug Interactions

None significant

Clinical Pearls

Higher concentration of surfactant protein than beractant
Given every 12 hours (vs. 6 hours for beractant)
Refrigerate; do not shake
Contains SP-B and SP-C — biophysically active

Mnemonic

💡 Infasurf = Infant Surfactant (calfactant)

NBRC High-Yield

Calfactant (Infasurf) — 3 mL/kg intratracheal for RDS
Contains SP-B and SP-C surfactant proteins
Repeat dosing q12h (vs. q6h for beractant)
Monitor for rapid compliance changes requiring vent adjustment

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