Update in Surfactant Therapy

Abstract

Exogenous surfactant is one of only a handful of neonatal therapies that has a strong evidence base, the product of countless basic and clinical studies over roughly 30 years between the first report of respiratory distress syndrome (RDS) as surfactant deficiency and the Food and Drug Administration (FDA) approval of the first surfactant preparation. Why then has surfactant therapy not succeeded in other neonatal, pediatric, or adult diseases associated with deficient or dysfunctional surfactant? By reflecting on the successes of surfactant therapy for RDS and examining critically the current evidence base for surfactant therapy in other neonatal pulmonary diseases, the authors chart a course for the future of surfactant therapy in neonatology.