Failure of surfactant therapy

• Insufficient dose

• Poor distribution

• Excessive inhibition

• Catabolism

• Dilution or lack of endogenous synthesis

• Delay in administration

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Several factors can affect the efficacy of surfactant supplementation.The type of surfactant used and the time of application play a more important role than the dose utilized.

Exogenous surfactant therapy does not represent an aetiological therapy but leads to better ventilation and stabilization of terminal bronchioles and alveoli, and consequently can play an important role in protective lung strategy.