Lung Surfactants

Lung surfactants are neonatal respiratory medications used primarily for respiratory distress syndrome (RDS) in premature infants. They are not bronchodilators, steroids, mucolytics, or oxygen. They are replacement substances that restore the surface-active material that immature lungs cannot produce in adequate amounts. For RN practice, the key learning point is this: surfactant improves alveolar stability. After administration, the infant’s lung compliance can improve quickly, which means the ventilator settings and oxygen concentration may need rapid adjustment to prevent overventilation, volutrauma, hyperoxia, or air leak complications. Current neonatal guidance supports early selective rescue surfactant for worsening RDS rather than routine prophylactic surfactant for all preterm infants managed initially with noninvasive support.