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Surfactant therapy is the medical administration of pulmonary surfactant that is derived from outside of the body. Pulmonary surfactant is a soap-like chemical synthesized by type II alveolar pneumocytes and is of various lipids (80% phospholipids, 5-10% cholesterol, and ∼10% surfactant-associated proteins).
Surfactant administration can also be effective in meconium aspiration syndrome where it has been shown to help lower length of stay. [7] [8] For patients with acute respiratory distress syndrome (ARDS), surfactant has not been shown to reduce mortality. However, it may be beneficial in those with COVID-19 associated ARDS.
Pulmonary surfactant thus greatly reduces surface tension, increasing compliance allowing the lung to inflate much more easily, thereby reducing the work of breathing. It reduces the pressure difference needed to allow the lung to inflate. The lung's compliance, and ventilation decrease when lung tissue becomes diseased and fibrotic. [3]
Pulmonary surfactant is a complex system of lipids, proteins and glycoproteins that is produced in specialized lung cells called Type II cells or Type II pneumocytes. The surfactant is packaged by the cell in structures called lamellar bodies, and extruded into the air spaces. The lamellar bodies then unfold into a complex lining of the air space.
Whole lung lavage (WLL), also called lung washing, is a medical procedure in which the patient's lungs are washed with saline (salt water) by filling and draining repeatedly. It is used to treat pulmonary alveolar proteinosis , in which excess lung surfactant proteins prevent the patient from breathing.
Lung surfactant (LS) is a surface-active material produced by most air-breathing animals for the purpose of reducing the surface tension of the water layer where gas exchange occurs in the lungs, given that the movements due to inhalation and exhalation may cause damage if there is not enough energy to sustain alveolar structural integrity.
Pulmonary drug delivery is a route of administration in which patients use an inhaler to inhale their medications and drugs are absorbed into the bloodstream via the lung mucous membrane. This technique is most commonly used in the treatment of lung diseases, for example, asthma and chronic obstructive pulmonary disease (COPD) .
Poractant alfa is a pulmonary surfactant sold under the brand name Curosurf by Chiesi Farmaceutici. Poractant alfa is an extract of natural porcine lung surfactant. As with other surfactants, marked improvement on oxygenation may occur within minutes of the administration of poractant alfa.