Clinical applications of exogenous pulmonary surfactant

It is now widely recognized that surfactant replacement is a potential life-saving therapy in babies with severe respiratory distress syndrome. The most striking acute effects have been obtained with modified natural surfactant preparations containing both surface active lipids and the hydrophobic proteins, surfactant protein B and surfactant protein C. Clinical applications of exogenous surfactant have become increasingly important. Mechanisms of surfactant inactivation have also been studied extensively in recent years. Data from animal experiments as well as clinical pilot studies indicate that the inactivation of surfactant can be overcome by large doses of exogenous surfactant. The resistance of surfactant to inhibition seems to depend on the presence of surfactant protein A. Exogenous surfactants for treatment of patients with acute respiratory distress syndrome and similar conditions must therefore be carefully designed to resist inhibition.