Surfactant Therapy in Respiratory Distress Syndrome

Respiratory distress syndrome (RDS) is the leading cause of neonatal respiratory morbidity and mortality. Advancements in neonatal care, along with extended insurance coverage, have resulted in increased utilization of surfactant replacement therapy (SRT) for RDS. This has contributed to a decrease in neonatal mortality. The primary mode of respiratory support in infants with RDS has dramatically changed over the last decades, transitioning from invasive to noninvasive support. Therefore, less invasive surfactant therapy has emerged as a widely adopted approach for SRT, establishing itself as a standard method in preterm infants’ care. This review addresses pulmonary surfactant, from its discovery to application in newborns with RDS. It also reviews the history of guidelines of SRT and health insurance issues. Future studies should evaluate various emerging noninvasive respiratory support modalities along with SRT for the respiratory management of neonates, given the lack of sufficient evidence regarding these approaches.