Government hospitals across Tamil Nadu are facing a shortage of surfactant medicines, a critical and life-saving medicine for pre-term babies.
They utilised external bovine or porcine surfactants (intratracheal) in pre-term babies. These surfactants were part of the speciality drug rate contract purchases of the Tamil Nadu Medical Services Corporation (TNMSC). “First, we got no allotment. Secondly, some centres miscalculated their requirement, which is based on the average number of pre-term babies delivered, and thirdly, there was higher utilisation. “Currently, we are borrowing from other sub-centres which are referring babies to us. It is very difficult for us to manage newborn units without surfactants. “However, in very pre-term babies, the alveoli, which are the tiny air sacs in the lungs, may not be sufficiently mature to function effectively on their own. Surfactant, a substance produced in the lungs, helps keep the alveoli open. But in babies born very prematurely, not enough surfactant may be produced, making it difficult for them to maintain adequate oxygen levels. Depending on the baby’s condition, doctors may use respiratory support such as CPAP or a mechanical ventilator. Surfactant is delivered directly into the lungs through the endotracheal tube to prevent hyaline membrane disease.”
A senior paediatrician said that after 34 weeks of gestation, the foetal lungs are generally mature enough to support exchange of oxygen and carbon dioxide after birth.
Doctors said surfactant medicines are essential to inflate the lungs of pre-term babies in need of the therapy. A doctor, speaking on condition of anonymity, said the shortage prevailed in the past three to four months owing to a number of factors. This is a life-saving medicine essential to inflate the lungs of pre-term babies who are otherwise solid,” he said. A doctor at another hospital said continuous supply was not assured, and shortage occurred frequently. Sometimes, we purchase them privately using SNCU funds to save the babies,” another doctor said.
