Overview
Introduction
A premature infant whose type II pneumocytes have not yet produced enough phospholipid‑protein surfactant will struggle to keep alveoli open.
A premature infant whose type II pneumocytes have not yet produced enough phospholipid‑protein surfactant will struggle to keep alveoli open. The resulting atelectasis drives the rapid rise in work of breathing that defines respiratory distress syndrome (RDS). Exogenous surfactant replaces what the lung cannot make, immediately lowering surface tension, recruiting collapsed units, and permitting the ventilator to deliver tidal volumes at lower pressures. The decision to give surfactant hinges on two clinical checkpoints: how much oxygen the infant needs to stay within the target SpO₂ range, and how early the airway can be secured.