What is the standard initial dose for poractant alfa (Curosurf) surfactant in preterm neonates?

• A. 150 mg/kg
• B. 200 mg/kg
• C. 100 mg/kg
• D. 250 mg/kg

Answer: (B)

The key idea is how poractant alfa is dosed at the start. For Curosurf, the recommended initial amount given to a preterm neonate with surfactant deficiency is 200 mg per kilogram of birth weight. This is typically administered as 2.5 mL/kg of the 80 mg/mL preparation. If the infant’s respiratory status remains concerning after the first dose, a second dose of 100 mg/kg may be given within the first hours to optimize lung function. This higher initial dose helps achieve rapid, more even distribution of surfactant in the lungs and improves treatment efficacy compared with lower initial doses.