What is Beractant used for?

Introduction to Beractant:

Beractant, most commonly known by its trade name Survanta, is a surfactant used primarily in the treatment and prevention of respiratory distress syndrome (RDS) in premature infants. Developed by Abbott Laboratories and now under the umbrella of AbbVie Inc., this drug has been a cornerstone in neonatal care. Beractant is a member of the exogenous surfactant therapy class. Its use is indicated for premature infants with or at risk of developing RDS, which is often due to a deficiency in pulmonary surfactant—a substance produced by the lungs that reduces surface tension and prevents the alveoli from collapsing.

The development of Beractant was an important milestone in neonatology, significantly improving the survival rates and reducing the incidence of complications associated with prematurity. Research institutions and hospitals globally have participated in multiple clinical trials and studies to establish the safety and efficacy of Beractant. The research progress has been substantial, leading to FDA approval in the early 1990s. Nowadays, Beractant is a standard treatment protocol in neonatal intensive care units (NICUs) around the world.

Beractant Mechanism of Action:

Beractant is a naturally derived surfactant, consisting of phospholipids, neutral lipids, fatty acids, and surfactant-associated proteins that mimic the natural surfactant produced in the human lungs. The primary component is phosphatidylcholine, which makes up about 75% of the total phospholipid content. The surfactant proteins, particularly SP-B and SP-C, play a crucial role in spreading the surfactant across the alveolar surface and stabilizing the alveoli during respiration.

When administered intratracheally, Beractant lowers the surface tension within the alveoli. This reduction in surface tension prevents alveolar collapse during exhalation, thereby improving oxygenation and promoting uniform lung expansion. By replacing the deficient natural surfactant, Beractant helps to re-establish functional residual capacity, enhances lung compliance, and facilitates better gas exchange. This mechanism is vital for preterm infants whose lungs are underdeveloped and incapable of producing sufficient endogenous surfactant.

How to Use Beractant:

Beractant is administered intratracheally, meaning it is delivered directly into the trachea. This is typically done through an endotracheal tube, which is a plastic tube inserted into the windpipe. The drug is administered in a series of aliquots, and the infant is repositioned between aliquots to ensure even distribution throughout the lungs. The standard dosage is 100 mg of phospholipids per kilogram of birth weight, and up to four doses can be given in the first 48 hours of life if necessary.

The onset of action for Beractant is relatively rapid. Clinical improvements in oxygenation and lung compliance can be observed within minutes after administration. This quick onset is crucial in emergency settings, where timely intervention can significantly influence the outcomes. The infant's condition is closely monitored using blood gases, chest radiographs, and clinical assessment to gauge the effectiveness of the treatment and to decide if additional doses are required.

What is Beractant Side Effects:

While Beractant has been life-saving for many infants, it is not without potential side effects. Common adverse reactions may include a transient drop in oxygen levels (oxygen desaturation) and a slow heart rate (bradycardia) during administration. These effects are typically transient and can be managed with appropriate ventilatory support and monitoring.

Other potential side effects include hypotension (low blood pressure), endotracheal tube blockage, and pulmonary hemorrhage (bleeding into the lungs). Pulmonary hemorrhage is a serious but rare complication that requires immediate medical intervention. Because these infants are critically ill, it's sometimes challenging to differentiate between side effects of the drug and complications of their underlying condition.

Contraindications for Beractant are relatively limited, but it should be used cautiously in infants with known hypersensitivity to any component of the drug. Additionally, it is contraindicated in infants with conditions that may be exacerbated by fluid overload or those with congenital anomalies incompatible with life.

What Other Drugs Will Affect Beractant:

Interactions between Beractant and other medications are not well-documented, largely due to the specific and limited patient population it serves. However, several factors need to be considered when administering Beractant in conjunction with other treatments.

Firstly, other surfactant preparations should not be administered simultaneously with Beractant. Doing so could potentially alter the drug's efficacy and safety profile. Secondly, medications that impact lung function or fluid balance, such as diuretics and certain bronchodilators, may interact with the efficacy of Beractant. Clinical judgment should be used to assess the necessity and timing of these medications in coordination with Beractant therapy.

Another aspect to consider is the role of concurrent ventilatory support. Positive pressure ventilation is often used in tandem with Beractant administration to help distribute the surfactant evenly across the alveoli. Therefore, drugs that affect respiratory drive or muscle function should be monitored closely.

In conclusion, Beractant has revolutionized the management of respiratory distress syndrome in preterm infants. Its mechanism of action, rapid onset, and relatively manageable side effect profile make it an invaluable tool in neonatal intensive care. Ongoing research and clinical experience continue to refine its use, promising even better outcomes for the most vulnerable patients.