Abstract

Surfactant treatment is standard of care for infants who have respiratory distress syndrome (RDS). However, many practical questions remain about what RDS is, and who should be treated and when. This review will attempt to answer these questions on the basis of new clinical trials and a perspective on the goals of treatment. Clinical data now support an initial use of continuous positive airway pressure to stabilize most infants before treatment, but the optimal way to treat an infant is under intense investigation. The best treatment option for an infant ultimately depends on gestational age, clinical status, and the experience of the clinician. The differences in surfactants are minor given the low rates of complications with any surfactant treatment. The clinical management of RDS is the greatest success story in neonatology.

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