Frequently Asked Questions

You have 2 options for intratracheally administering CUROSURF.¹

CUROSURF should be administered by, or under the supervision of clinicians experienced in intubation, ventilator management, and general care of premature infants.¹ Before administering CUROSURF, assure proper placement and patency of the endotracheal tube. At the discretion of the clinician, the endotracheal tube may be suctioned before administering CUROSURF. Allow the infant to stabilize before proceeding with dosing.

You should use the full administration instructions in the Full Prescribing Information.

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The initial dose of CUROSURF is 2.5 mL/kg birth weight, administered intratracheally. Up to 2 repeat doses of 1.25 mL/kg birth weight each may be given at approximately 12-hour intervals if Respiratory Distress Syndrome (RDS) is still present and causing respiratory deterioration. The maximum total recommended dosage (sum of initial and up to 2 repeat doses) is 5 mL/kg birth weight.¹

The dosing is based on the infant’s birth weight.¹ No specific adjustments are recommended based on gestational age or other patient factors in the available prescribing information.¹ Learn more about CUROSURF dosing.

• CUROSURF should only be administered by HCPs trained and experienced in the care, resuscitation, and stabilization of preterm infants¹
• Maximum recommended total dosage (sum of the initial and up to 2 repeat doses) is 5 mL/kg birth weight¹
• Sustained reduction of FiO₂ levels over 48 hours may reduce the need for redosing¹¹
• A meta-analysis showed that early administration of surfactant led to a decreased risk for acute lung injury, mortality, and chronic lung disease compared with infants treated with surfactant later in treatment¹²

INSURE: INtubation SURfactant Rapid Extubation

The INSURE* strategy involves administering surfactant as a rescue treatment for infants with RDS at the discretion of the clinician and when the infant is stable.¹³ The AAP strongly recommends this approach if nasal CPAP has failed.¹³ The INSURE strategy offers the benefits of surfactants while potentially prolonging or avoiding mechanical ventilation.¹⁴ In some clinical trials, infants treated with CUROSURF using the INSURE strategy were generally extubated within approximately 5 to 10 minutes following surfactant administration.^15-18 Explore the INSURE strategy.

*It is important to note that the INSURE strategy may not be appropriate for all infants. Infants with RDS may vary markedly in the severity of respiratory disease, maturity, and presence of other complications, and thus it is necessary to individualize patient care.

The decision for early rescue should be based on a multifactorial risk, including infant and maternal factors that can contribute to an increased risk for RDS and CPAP failure^19-22

• Infant factors include <32 weeks gestational age, cesarean delivery, hypothermia, low birth weight, APGAR score ≤3 at 1 minute and Silverman score >2 at 2 hours, high oxygen requirements, and clinical subjective respiratory signs^21-23
• Maternal factors include no antenatal steroid use, premature rupture of membranes, comorbidities, nutritional status, smoking, and exposure to air pollution^19,20,24,25

Learn more about Early Rescue and the importance of multifactorial risk assessment in its initiation.