Neonatal Surfactant Therapy for Respiratory Distress Syndrome

A 27-week infant develops grunting, retractions, and tachypnea during the first hours after birth. The infant is supported with CPAP, but the FiO₂ keeps rising and the work of breathing is worsening. That pattern should make surfactant-deficient RDS the working hypothesis and prompt the neonatal team to assess for early selective rescue therapy. The nurse watches two linked changes: how hard the infant is working to breathe and how much oxygen is required to maintain saturation. Surfactant is added to respiratory support; it does not replace airway assessment, CPAP, or ventilation. It can also improve lung compliance within minutes, so the same pressure that was previously needed may become excessive after treatment.