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doi:10.1378/chest.06-2371
(Chest. 2007; 131:1577-1582)
© 2007 American College of Chest Physicians
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Right arrow Topics in Practice Management

Surfactant Replacement Therapy*

Timothy P. Stevens, MD, MPH and Robert A. Sinkin, MD, MPH

* From the Golisano Children’s Hospital at Strong (Dr. Stevens), University of Rochester, Rochester, NY; and the University of Virginia Children’s Hospital (Dr. Sinkin), Charlottesville, VA.

Correspondence to: Robert A. Sinkin, MD, MPH, University of Virginia Children’s Hospital, Division Chief, Neonatology, PO Box 800386, Charlottesville, VA 22908-0386; e-mail: ras9q{at}virginia.edu

Abstract

Surfactant replacement therapy (SRT) has a proven role in the treatment of neonatal respiratory distress syndrome and severe meconium aspiration syndrome in infants, and may have a role in the treatment of pediatric patients with ARDS. Although newer delivery mechanisms and strategies are being studied, the classic surfactant administration paradigm consists of endotracheal intubation, surfactant instillation into the lung, and stabilization with mechanical ventilation followed by extubation when stable on low respiratory support. Currently, this surfactant administration procedure is bundled into Current Procedural Terminology (CPT) codes used when providing intensive care. A specific CPT code for surfactant administration is scheduled to be introduced in 2007. This article reviews clinical issues in SRT and the practice management considerations necessary to provide this care.

Key Words: neonatology • respiratory failure • surfactant






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