General Information

Infasurf (calfactant) is a sterile, non-pyrogenic lung surfactant.

Infasurf is specifically indicated for the prevention of Respiratory Distress Syndrome (RDS) in premature infants at high risk for RDS and for the treatment (“rescue”) of premature infants who develop RDS. Infasurf decreases the incidence of RDS, mortality due to RDS, and air leaks associated with RDS.

• Prophylaxis
  • Prophylaxis therapy at birth with Infasurf is indicated for premature infants <29 weeks of gestational age at significant risk for RDS. Infasurf prophylaxis should be administered as soon as possible, preferably within 30 minutes after birth.
• Treatment
  • Infasurf therapy is indicated for infants ≤72 hours of age with RDS (confirmed by clinical and radiologic findings) and requiring endotracheal intubation.

Infasurf should be administered under the supervision of clinicians experienced in the acute care of newborn infants with respiratory failure who require intubation. Rapid and substantial increases in blood oxygenation and improved lung compliance often follow Infasurf instillation. Close clinical monitoring and surveillance following administration may be needed to adjust oxygen therapy and ventilator pressures appropriately.

Infasurf should only be administered intratracheally through an endotracheal tube. The dose of Infasurf is 3 mL/kg birth weight. The dose is drawn into a syringe from the single-use vial using a 20-gauge or larger needle with care taken to avoid excessive foaming. Administration is made by instillation of the Infasurf suspension into the endotracheal tube. Infasurf has been administered every 12 hours for a total of up to 3 doses.

Mechanism of Action

Infasurf (calfactant) is a sterile, non-pyrogenic lung surfactant. Endogenous lung surfactant is essential for effective ventilation because it modifies alveolar surface tension thereby stabilizing the alveoli. Lung surfactant deficiency is the cause of Respiratory Distress Syndrome (RDS) in premature infants. Infasurf restores surface activity to the lungs of these infants.

Side Effects

Adverse effects associated with the use of Infasurf may include, but are not limited to, the following:

• cyanosis
• airway obstruction
• bradycardia
• reflux of surfactant into the endotracheal tube
• requirement for manual ventilation
• reintubation

Clinical Trial Results

The efficacy of Infasurf was demonstrated in two multiple-dose controlled clinical trials involving approximately 2,000 infants treated with Infasurf (approximately 100 mg phospholipid/kg) or Exosurf Neonatal. In addition, two controlled trials of Infasurf versus Survanta, and four uncontrolled trials were conducted that involved approximately 15,500 patients treated with Infasurf.