Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Let’s be judicious in our use of surfactant

Danielle Moriates, RN
Conditions
January 29, 2015
Share
Tweet
Share

When babies are born prematurely, they often lack surfactant: a soapy substance produced in the lungs that helps to keep the air sacs open. Without surfactant, these tiny babies fight to breathe, a condition known as infant respiratory distress syndrome. Within the past 50 years, the delivery of artificial surfactant therapy has revolutionized neonatal care, saving many lives that previously would have had no chance at survival. As a neonatal intensive care nurse, I have seen firsthand how much relief and satisfaction it can bring patients when, within seconds of administration, it relieves a baby’s suffering and oxygen saturation soars from deadly levels to a much healthier 90+ percent. Suddenly, everybody in the room can breathe a little easier.

This dramatic effect likely explains why practitioners might be so eager to administer this magical (and expensive) drug. However, it often may not actually be necessary. While it has been a controversial subject, recent studies have proven that treating only those babies who develop signs of respiratory distress syndrome with surfactant as opposed to treating every premature baby that is born not only produces clinical outcomes that are just as good, but perhaps even better. It has been shown that if every premature infant is first treated using a simple, non-invasive treatment called continuous positive airway pressure (CPAP) and only given surfactant replacement if needed, significantly fewer surfactant doses would be administered without an increase in morbidity or mortality.

Surfactant is incredibly effective but exceptionally expensive. It’s not just that surfactant is financially costly, but the treatment comes with some medical risks, which should always be minimized as much as possible. Using Surfactant in place of much cheaper options such as CPAP can hinder the patient’s family financially and lead to a much more difficult care process for the family. It is our job as caregivers to ensure that we consider all treatment options and weigh those alongside the potential financial outcomes.

It amazes me that, somehow, despite the existence of sound medical research favoring certain treatment plans, there are hospitals all across the country that choose to continue with more costly approaches that offer no additional benefits to the patient. As a newly graduated nurse, I have entered into the medical community eager and enthusiastic to protect and better the lives of my patients and their families, and I can already see how much room there is for improvement in the current system.

As my attending emphasized to everyone as I drew up a dose of surfactant for one of our patients earlier this week, “One drop of that stuff costs more than your lunch today!” When needed to save a precious new life, we should probably not think twice about the cost of a drug; however, when 78 percent of the doses that are given at birth could have been avoided, nurses need to ensure that they encourage less costly options.

Danielle Moriates is a nurse.

costs_of_care_logo_small

This post originally appeared on the Costs of Care Blog. Costs of Care is a 501c3 nonprofit that is transforming American health care delivery by empowering patients and their caregivers to deflate medical bills. Follow us on Twitter @costsofcare.

Prev

Doctors who attack other physicians

January 29, 2015 Kevin 9
…
Next

Stop with the curbside consultations. They don't help anyone.

January 29, 2015 Kevin 15
…

Tagged as: Pediatrics

Post navigation

< Previous Post
Doctors who attack other physicians
Next Post >
Stop with the curbside consultations. They don't help anyone.

ADVERTISEMENT

More in Conditions

  • The emotional toll of leaving patients behind

    Dr. Damane Zehra
  • Peripheral artery disease prevention: Saving limbs and lives

    Wei Zhang, MBBS, PhD
  • A clinician’s guide to embryo grading in IVF

    Erica Bove, MD
  • Why women’s symptoms are dismissed in medicine

    Shannon S. Myers, FNP-C
  • GLP-1 psychological side effects: a psychiatrist’s view

    Farid Sabet-Sharghi, MD
  • Emotional awareness and expression therapy explained

    David Clarke, MD
  • Most Popular

  • Past Week

    • Why patient trust in physicians is declining

      Mansi Kotwal, MD, MPH | Physician
    • “The meds made me do it”: Unpacking the Nick Reiner tragedy

      Arthur Lazarus, MD, MBA | Meds
    • Why insurance must cover home blood pressure monitors

      Soneesh Kothagundla | Conditions
    • Is tramadol really ineffective and risky?

      John A. Bumpus, PhD | Meds
    • The dangers of oral steroids for seasonal illness

      Megan Milne, PharmD | Meds
    • 5 things health care must stop doing to improve physician well-being

      Christie Mulholland, MD | Physician
  • Past 6 Months

    • Why patient trust in physicians is declining

      Mansi Kotwal, MD, MPH | Physician
    • The blind men and the elephant: a parable for modern pain management

      Richard A. Lawhern, PhD | Conditions
    • Is primary care becoming a triage station?

      J. Leonard Lichtenfeld, MD | Physician
    • Psychiatrists are physicians: a key distinction

      Farid Sabet-Sharghi, MD | Physician
    • Why feeling unlike yourself is a sign of physician emotional overload

      Stephanie Wellington, MD | Physician
    • Accountable care cooperatives: a community-owned health care fix

      David K. Cundiff, MD | Policy
  • Recent Posts

    • From law to medicine: Witnessing trauma on the Pacific Coast Highway

      Scott Ellner, DO, MPH | Physician
    • Why doctors struggle with treating friends and family

      Rebecca Margolis, DO and Alyson Axelrod, DO | Physician
    • The emotional toll of leaving patients behind

      Dr. Damane Zehra | Conditions
    • Peripheral artery disease prevention: Saving limbs and lives

      Wei Zhang, MBBS, PhD | Conditions
    • Artificial intelligence ends the dangerous cycle of delayed patient care [PODCAST]

      The Podcast by KevinMD | Podcast
    • A simple nocturia management technique for seniors

      Neil R. M. Buist, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 1 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why patient trust in physicians is declining

      Mansi Kotwal, MD, MPH | Physician
    • “The meds made me do it”: Unpacking the Nick Reiner tragedy

      Arthur Lazarus, MD, MBA | Meds
    • Why insurance must cover home blood pressure monitors

      Soneesh Kothagundla | Conditions
    • Is tramadol really ineffective and risky?

      John A. Bumpus, PhD | Meds
    • The dangers of oral steroids for seasonal illness

      Megan Milne, PharmD | Meds
    • 5 things health care must stop doing to improve physician well-being

      Christie Mulholland, MD | Physician
  • Past 6 Months

    • Why patient trust in physicians is declining

      Mansi Kotwal, MD, MPH | Physician
    • The blind men and the elephant: a parable for modern pain management

      Richard A. Lawhern, PhD | Conditions
    • Is primary care becoming a triage station?

      J. Leonard Lichtenfeld, MD | Physician
    • Psychiatrists are physicians: a key distinction

      Farid Sabet-Sharghi, MD | Physician
    • Why feeling unlike yourself is a sign of physician emotional overload

      Stephanie Wellington, MD | Physician
    • Accountable care cooperatives: a community-owned health care fix

      David K. Cundiff, MD | Policy
  • Recent Posts

    • From law to medicine: Witnessing trauma on the Pacific Coast Highway

      Scott Ellner, DO, MPH | Physician
    • Why doctors struggle with treating friends and family

      Rebecca Margolis, DO and Alyson Axelrod, DO | Physician
    • The emotional toll of leaving patients behind

      Dr. Damane Zehra | Conditions
    • Peripheral artery disease prevention: Saving limbs and lives

      Wei Zhang, MBBS, PhD | Conditions
    • Artificial intelligence ends the dangerous cycle of delayed patient care [PODCAST]

      The Podcast by KevinMD | Podcast
    • A simple nocturia management technique for seniors

      Neil R. M. Buist, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Let’s be judicious in our use of surfactant
1 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...