What happens to surfactant in ARDS?

Surfactant can reduce alveolar surface tension, thereby preventing alveolar collapse. Furthermore, pulmonary surfactant can enhance phagocytes function and maintain immune response in the patients of ARDS [3]. The mechanisms of action for surfactant in ARDS were detailed in Table 1.

What is exogenous surfactant?

Exogenous surfactant is a therapeutic option for newborns, children and adults with acute respiratory distress disorders. Although tracheal instillation is still reputed as the classical method of surfactant delivery, alternative techniques have been investigated.

How does exogenous surfactant work?

By lowering and varying alveolar surface tension, lung surfactant maintains a low physiological work of breathing, stabilizes small alveoli against collapse (atelectasis), improves the overall uniformity of alveolar inflation, and reduces the hydrostatic driving force for pulmonary edema.

How do you give an exogenous surfactant?

Methods to deliver surfactant The surfactant is administered via a thin catheter into the trachea in small aliquots, while the baby is spontaneously breathing on CPAP support. In infants 29-32 weeks gestation, LISA may reduce the occurrence of pneumothorax and need for mechanical ventilation.

Is ARDS caused by surfactant deficiency?

Surfactant deficiency and inactivation will further induce alveolar collapse and pulmonary oedema, leading to the characteristic pathophysiology of ARDS.

What is the role of surfactant in lungs?

The main functions of surfactant are as follows: (1) lowering surface tension at the air–liquid interface and thus preventing alveolar collapse at end-expiration, (2) interacting with and subsequent killing of pathogens or preventing their dissemination, and (3) modulating immune responses.

What is artificial surfactant?

Synthetic surfactant is effective in reducing respiratory distress syndrome in preterm babies. Pulmonary surfactant is a substance that prevents the air sacs of the lungs from collapsing by reducing surface tension. Sometimes it is absent in immature lungs and respiratory distress syndrome (RDS) can develop.

What is artificial surfactant made of?

Synthetic pulmonary surfactants: Colfosceril palmitate (Exosurf) – a mixture of DPPC with hexadecanol and tyloxapol added as spreading agents. Pumactant (Artificial Lung Expanding Compound or ALEC) – a mixture of DPPC and PG.

When should surfactant be given?

Ideally the dose should be given within 1 hr of birth but definitely before 2 hours of age. A repeat dose should be given within 4 – 12 hours if the patient is still intubated and requiring more than 30 to 40% oxygen.

How surfactant prevent pulmonary edema?

We conclude that surfactant normalizes surface tension and decreases transcapillary hydrostatic forces in this lung injury model, thereby reducing edema formation and improving gas exchange.

Which phospholipid is deficient in respiratory distress syndrome?

Respiratory distress syndrome is caused by a deficiency of surfactant, a phospholipid responsible for stabilizing alveolar surfaces and reducing surface tension. Surfactant is 70% lipid (phosphatidylcholine) combined with proteins.

How does surfactant prevent lung collapse?

Surfactant is released from the lung cells and spreads across the tissue that surrounds alveoli. This substance lowers surface tension, which keeps the alveoli from collapsing after exhalation and makes breathing easy.