October 28, 2013

Guideline Title

AARC clinical practice guideline. Surfactant replacement therapy: 2013.

Bibliographic Source(s)

Walsh BK, Daigle B, Diblasi RM, Restrepo RD. AARC clinical practice guideline. Surfactant replacement therapy: 2013. Respir Care. 2013 Feb;58(2):367-75. [90 references] PubMed External Web Site Policy

Guideline Status

This is the current release of the guideline.
This guideline updates a previous version: American Association for Respiratory Care (AARC). AARC clinical practice guideline. Surfactant replacement therapy. Respir Care. 1994 Aug;39(8):824-9. [62 references]

AARC Clinical Practice Guideline. Surfactant rep... [Respir Care. 2013] - PubMed - NCBI

2013 Feb;58(2):367-75. doi: 10.4187/respcare.02189.

AARC Clinical Practice Guideline. Surfactant replacement therapy: 2013.

Walsh BK, Daigle B, DiBlasi RM, Restrepo RD.

Source

Respiratory Care Department, Children's Medical Center, Dallas, TX 75235, USA. Brian.Walsh@childrens.com

Abstract

We searched the MEDLINE, CINAHL, and Cochrane Library databases for English-language randomized controlled trials, systematic reviews, and articles investigating surfactant replacement therapy published between January 1990 and July 2012. By inspection of titles, references having no relevance to the clinical practice guideline were eliminated. The update of this clinical practice guideline is based on 253 clinical trials and systematic reviews, and 12 articles investigating surfactant replacement therapy. The following recommendations are made following the Grading of Recommendations Assessment, Development, and Evaluation scoring system: 1: Administration of surfactant replacement therapy is strongly recommended in a clinical setting where properly trained personnel and equipment for intubation and resuscitation are readily available. 2: Prophylactic surfactant administration is recommended for neonatal respiratory distress syndrome (RDS) in which surfactant deficiency is suspected. 3: Rescue or therapeutic administration of surfactant after the initiation of mechanical ventilation in infants with clinically confirmed RDS is strongly recommended. 4: A multiple surfactant dose strategy is recommended over a single dose strategy. 5: Natural exogenous surfactant preparations are recommended over laboratory derived synthetic suspensions at this time. 6: We suggest that aerosolized delivery of surfactant not be utilized at this time.
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