Abstract
Independent of the cause, in ARDS there is a disturbed permeability of the alveolo-capillary membrane with influx of plasma proteins. These plasma proteins can inhibit the surfactant system, and therefore, in ARDS there is always a pathologically changed surface tension at the air-liquid interface because of the capillary leakage. This decreased surface tension is most easily normalized by application of exogenous surface active material. Numerous case reports but also the first clinical studies confirm this rational treatment concept.
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