The Role of Surfactant Therapy in Nonrespiratory Distress Syndrome Conditions in Neonates

While treatment of respiratory distress syndrome (RDS) with surfactant in premature neonates is well established, evidence for its use in non-RDS conditions, especially in the term neonate, has been less abundant. The last published review on a PubMed search was in 2001. In this review, we comprehensively and critically evaluated the evidence from the literature regarding the use of surfactant in specific non-RDS disorders in neonates. Surfactant administered as a bolus should be considered in the treatment of meconium aspiration syndrome with progressive respiratory failure. While controversial in congenital diaphragmatic hernia, it should be considered in Group B streptococcal pneumonia. As evidence evolves, we anticipate the broader application and more routine use of surfactant therapy for respiratory failure because of causes other than RDS.