Surfactant in adult respiratory distress syndrome

Adult Respiratory Distress Syndrome is a catastrophic disease which is characterized by tachypnoea, arterial hypoxemia, reduced pulmonary compliance, and diffuse alveolar infiltrates. The pathology is that of diffuse alveolar damage which includes injury to both endothelial cells and type I epithelial cells. The major physiological abnormality is reduced pulmonary compliance. The available data indicate that one of the causes for the reduced compliance is altered surface tension in the distal airspaces. Pulmonary surface material isolated from patients with Adult Respiratory Distress Syndrome has an altered phospholipid composition. Part of the current therapy is to overcome the reduced compliance by mechanical ventilation while allowing the lung time to heal. In the future, exogenous surfactant may also be used as part of the therapy in selected severely ill patients.