Beractant is a specialized medication used to assist premature infants who experience breathing difficulties. This treatment is a type of lung surfactant, a substance naturally present in healthy lungs. It is designed to help the underdeveloped lungs of newborns function more effectively. Beractant is a standard component of care in neonatal intensive care units (NICUs) for infants with or at risk of respiratory distress syndrome (RDS).
The Role of Surfactant in Newborn Lungs
Healthy, full-term babies produce a natural substance in their lungs called surfactant. This complex mixture of lipids and proteins lines the tiny air sacs, known as alveoli. Surfactant reduces the surface tension within these air sacs, preventing them from collapsing completely when the baby exhales. Without enough surfactant, the delicate alveoli stick together, requiring significant effort for each breath.
Premature infants, especially those born before 34 weeks of gestation, often have underdeveloped lungs that do not produce sufficient natural surfactant. This deficiency leads to Infant Respiratory Distress Syndrome (IRDS). In IRDS, the lack of surfactant makes the lungs stiff and difficult to inflate, leading to poor oxygen exchange and increased work of breathing for the newborn. Without intervention, the condition can cause severe respiratory failure.
How Beractant is Used in Treatment
Beractant functions as a direct replacement for the natural surfactant that premature infants lack. When administered, it spreads across the inner surface of the alveoli, effectively lowering the surface tension. This action helps keep the air sacs open during exhalation, allowing for better lung expansion and more efficient oxygen and carbon dioxide exchange. The medication’s composition includes phospholipids and surfactant-associated proteins that mimic natural human surfactant.
The medication is administered directly into the infant’s lungs through an endotracheal tube, a breathing tube already in place for respiratory support in the NICU. Before administration, the beractant solution is warmed to room temperature. The liquid suspension is gently swirled, not shaken, to ensure a uniform mixture.
The administration procedure involves dividing the total dose into four equal parts. Each quarter-dose is instilled over a few seconds, with the infant’s position adjusted between doses to help distribute the medication evenly throughout the lungs. After the full dose is given, suctioning of the airway is generally avoided for at least one hour unless a significant obstruction occurs.
Monitoring and Potential Side Effects
Infants receiving beractant are under continuous, close observation in the NICU by trained medical professionals. Monitoring includes heart rate, blood pressure, oxygen saturation levels, and breathing patterns. This constant oversight allows the medical team to promptly identify and address any changes that may occur during or shortly after the administration of the medication.
Some transient effects can occur during the dosing procedure. These include a temporary decrease in heart rate (bradycardia) and a temporary drop in blood oxygen levels (oxygen desaturation). If these occur, beractant administration is temporarily stopped, and measures are taken to stabilize the infant before resuming. Other less common effects include noisy breathing, problems with feeding or bowel movements, and bleeding around the endotracheal tube. In rare instances, more severe issues like pulmonary hemorrhage have been reported.
Expected Outcomes for Infants
Treatment with beractant aims to significantly improve lung function in premature infants. Following administration, infants typically show improvements in breathing stability and oxygenation within minutes to hours. This enhancement in lung performance often leads to a reduced need for high levels of oxygen support and mechanical ventilation. The medication helps the infant’s lungs mature and begin producing their own surfactant more effectively.
Beractant has played a role in reducing both mortality and the occurrence of complications associated with Infant Respiratory Distress Syndrome. While the medication offers substantial benefits, the overall recovery of an infant depends on various factors, including their gestational age at birth and any other co-existing medical conditions. The use of beractant allows these vulnerable newborns to have a better opportunity for healthy respiratory development and improved long-term outcomes.