Pulmonary surfactant

The endogenous surfactant system produces stable low surface tension in the alveoli, preventing their collapse. Failure of production of natural surfactant occurs in respiratory distress syndrome (RDS), including that in the neonate. Synthetic phospholipids are now available for intratracheal instillation to act as surfactants: colfosceril palmitate, poractant alfa, and beractant. These need to be stored chilled, and the manufacturer's instructions followed carefully since on reaching body temperature their physicochemical properties rapidly change. Their function is to coat the surface of the alveoli and maintain their patency, and their administration to premature neonates with RDS is a key part in reducing mortality and long-term complications in this condition.

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