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Surfactant Replacement Therapy

Surfactant, a naturally produced substance, is a kind of foamy, fatty liquid that acts like grease within the lungs. Without it, the air sacs open but have difficulty remaining open because they stick together. Surfactant allows the sacs to remain open.

How Surfactant Works
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Surfactant usually appears in the fetus’s lungs at about the 24th week of pregnancy and gradually builds up to its full level by the 37th week. If a premature baby is lacking surfactant, artificial surfactant may be given. 

Surfactant is delivered using an artificial airway or breathing tube that is inserted into the trachea, or windpipe, either immediately at birth for extremely premature babies, or later once respiratory problems have revealed themselves. Surfactant is administered through the windpipe over the course of a few minutes. During this time, the baby will be turned and moved in an effort to distribute the surfactant to all parts of the lung. Depending on the severity of the lung condition, surfactant may be administered more than once.

Surfactant replacement therapy cannot begin until breathing has been stabilized, perhaps with mechanical ventilation, and the proper monitoring equipment has been set up.

Andrew James, MBChB, MBI, FRACP, FRCPC

Jaques Belik, MD, FRCPC