Review Explores Prophylactic vs. Selective Surfactant Strategies for Preterm Infant Respiratory Distress Syndrome

Respiratory distress syndrome (RDS), or hyaline membrane disease, is a leading cause of neonatal morbidity and mortality in preterm infants (< 37 weeks' gestation), particularly those extremely (< 28 weeks) or very preterm (28 to < 31 weeks). It stems from a deficiency of pulmonary surfactant, which reduces surface tension in alveoli, preventing atelectasis. Surfactant replacement therapy improves lung compliance, reduces ventilator support, and decreases pneumothorax risk, death, and bronchopulmonary dysplasia. Its widespread use has significantly improved preterm survival.