Resp Patho Surfactant Alveolar

Neonatal respiratory distress syndrome and adult acute respiratory distress syndrome share a mechanical problem but not the same cause. In a preterm infant, the lungs have not produced enough effective surfactant. In adult ARDS, a known insult injures the alveolar-capillary barrier and disables surfactant with protein-rich oedema. That difference determines the treatment logic: early selective surfactant replacement is central to neonatal RDS, whereas routine exogenous surfactant is not beneficial in adult ARDS. For the nurse, the important clinical pivot is the response of the lung. A preterm infant whose oxygen requirement is rising despite CPAP may need prompt surfactant and close ventilator weaning afterward. An adult with ARDS needs protection from further ventilator-induced injury, assessment of recruitability and oxygenation, and escalation through evidence-based support rather than automatic surfactant administration.