Calfactant

Calfactant Brand Name– Infasurf

What is Calfactant

Calfactant is a bovine-derived lung surfactant suspension.

It is administered intratracheally and is indicated for the prevention and treatment of respiratory distress syndrome (RDS) in premature infants.

Many different surfactants are available commercially; they can be derived from natural sources or synthesized. Infasurf and Survanta are bovine-derived while colfosceril-cetyl alcohol-tyloxapol (Exosurf Neonatal) and lucinactant are synthetic (see separate monographs).

Calfactant is obtained by lavaging bovine lungs, while beractant is derived from minced bovine lung tissue.

Similar to beractant, calfactant contains phospholipids, neutral lipids, fatty acids and two low-molecular weight, hydrophobic surfactant-associated proteins, SP-B and SP-C.

It does not contain the hydrophilic large molecular weight surfactant-associated protein SP-A. Based on clinical response and outcomes in neonates, most clinicians feel there is little difference between the currently available natural and synthetic exogenous surfactant products.

Surfactants are being investigated for use in other respiratory distress syndromes in both children and adults, including acute respiratrory distress syndrome (ARDS) and burn-inhalation injuries.

Final FDA approval of calfactant was granted in 1997.

However, the FDA delayed marketing of Infasurf until the orphan drug status for Survanta expired in July 1998.

The Infasurf product was made available after 2000.

Indications

  • acute respiratory distress syndrome (ARDS)
  • neonatal respiratory distress syndrome
  • neonatal respiratory distress syndrome prophylaxis

For neonatal respiratory distress syndrome prophylaxis in premature neonates and for the treatment of neonatal respiratory distress syndrome (RDS)

Side Effects

  1. bradycardia
  2. cyanosis
  3. hyperoxia
  4. hypocarbia
  5. hypoxia
  6. intracranial bleeding
  7. intraventricular hemorrhage

Monitoring Parameters

  • arterial blood gases (ABGs)
  • chest x-ray

Contraindications

  • bovine protein hypersensitivity
  • bradycardia
  • breast-feeding
  • pregnancy

Interactions

  • Amikacin
  • Amphotericin B
  • Gentamicin
  • Kanamycin
  • Neomycin
  • Paromomycin
  • Spectinomycin
  • Streptomycin
  • Tobramycin
  • Vancomycin
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