Surfactant replacement therapy in adult respiratory distress syndrome.

Pulmonary surfactant is a lipoprotein complex composed primarily of phospholipid and lung specific apoproteins that reduces surface tension in the alveolus and maintains alveolar stability at low lung volume. Adult respiratory distress syndrome still carries a very high morbidity and mortality. The surfactant system is vital to the maintenance of proper "lung function, any type of surfactant deficiency. whether primary or secondary, will contribute significantly to the development of pulmonar y pathophysiology. Various mechanisms in adult respiratory distress syndrome ma y be responsible for such alterations in the surfactant system. Surfactant replacement is now an estab. lished treatment for neonatal respiratory distress syndrome, reducing both incidence of complications and mortality. T ith the current knowledge of surfactant physiology and the pathophysiology of the adult respiratory distress syndrome exogenous surfactant treatment or stimulation of endogenous surfactant synthesis and secretion will prove to be beneficial in preventing and treating the adult respiratory distress syndrome. The study of clinical surfactant therapy for adult respiratory di stress syndrome is just beginnig and this can be viewed as an area with exciting potential. As soon as surfactant preparations become more widely avai lable trials should begin to define the role of surfactant treatment in the adult respiratory distress syndrome as an adjunct to available treatment techniques.