Learning Center/Pharmacology/Poractant Alfa

Poractant Alfa

Curosurf

surfactantintratrachealOnset: MinutesDuration: Variable

Mechanism of Action

Natural porcine surfactant extract. Highest phospholipid concentration of available surfactants (~80 mg/mL). Contains SP-B and SP-C. Reduces surface tension at the alveolar air-liquid interface.

Dosing

Neonatal

Initial: 200 mg/kg (2.5 mL/kg) intratracheally. Subsequent doses: 100 mg/kg (1.25 mL/kg) q12h; max 3 doses total

Indications

Rescue treatment of RDS in premature neonates
Prevention of RDS

Contraindications

None absolute in RDS setting

Side Effects

Bradycardia
O2 desaturation
ETT reflux/blockage

Monitoring Parameters

SpO2 and heart rate
Ventilator settings (rapid compliance improvement)
Blood gas

Drug Interactions

None significant

Clinical Pearls

Porcine-derived — highest phospholipid concentration of surfactants
Smaller volume dose than beractant for equivalent phospholipid content
Some evidence of faster response than beractant
Refrigerate; warm to room temperature; do not shake
Initial dose higher than repeat doses

Mnemonic

💡 Curosurf = CURe from pOrk (porcine) Surfactant

NBRC High-Yield

Porcine natural surfactant (Curosurf) — highest phospholipid concentration
Initial dose: 200 mg/kg; subsequent: 100 mg/kg q12h
Smaller volume than beractant for same phospholipid dose
Rescue treatment for RDS

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