Pump administration of exogenous surfactant: effects on oxygenation, heart rate, and chest wall movement of premature infants.

Adverse reactions of infants to surfactant administration include loss of chest wall movement and decrease in oxygen saturation and heart rate. We are aware of no previous studies addressing the administration of surfactant. We studied 22 infants with respiratory distress syndrome to determine whether these adverse reactions could be reduced by giving surfactant slowly by microinfusion syringe pump. Loss of chest wall movement was significantly greater in infants receiving surfactant by the hand-dosing method as compared with administration of surfactant by pump. A significant increase in ventilator pressure interventions was observed when surfactant was given by standard hand bolus method compared with pump infusion. Heart rate and oxygen saturation did not differ significantly between the two techniques. These findings suggest that pump administration of surfactant minimized potential airway obstruction; thus it may be an alternative to standard bolus dosing techniques.