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.

Surfactant usually appears in the fetus’s lungs at about the 24th week of pregnancy and gradually builds up to its full level by about the 35th 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 about half an hour. At regular intervals during this half hour, 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.

	SURFACTANT Surfactant. A fatty substance in the lungs that allows the lungs to expand and contract by preventing lung tissue from sticking together. Although surfactant is usually produced naturally in the body, naturally occurring surfactants obtained from pigs or cows, and artificial surfactants are used for treatment of some lung conditions. Premature babies often do not produce enough surfactant.

	TRACHEA Also called the “windpipe,” the trachea is the passage between the larynx at the base of the neck to the two main bronchi at the top of the lungs. The trachea carries air in and out of the lungs.

	AIRWAY The respiratory tract; the passage from the lungs to the outside world.