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. Author manuscript; available in PMC: 2014 Dec 23.
Published in final edited form as: Pediatr Clin North Am. 2008 Jun;55(3):545–ix. doi: 10.1016/j.pcl.2008.02.016

Figure 1. Schematic of the rationale for exogenous surfactant therapy to mitigate surfactant dysfunction in ALI/ARDS.

Figure 1

The pathophysiology of acute inflammatory lung injury includes surfactant dysfunction, which contributes to respiratory failure in term infants, children, and adults with clinical acute lung injury (ALI) and the acute respiratory distress syndrome (ARDS). Surfactant dysfunction reduces lung volumes and compliance, causes atelectasis and overdistension, increases ventilation/perfusion (V/Q) mismatching, and reduces gas exchange. In addition, surfactant dysfunction and lung injury can also be present in the clinical course of premature infants being treated with mechanical ventilation and supplemental oxygen for surfactant deficient lung disease in association with the neonatal respiratory distress syndrome (RDS). Scientific understanding indicates that surfactant dysfunction in lung injury can, at least in principle, be ameliorated by exogenous surfactant therapy as discussed in this article.