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How does surfactant really work?
Author(s) -
HILLS BA
Publication year - 1997
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/j.1440-1754.1997.tb01651.x
Subject(s) - pulmonary surfactant , medicine , penetration (warfare) , hypoxia (environmental) , surface tension , phospholipid , intensive care medicine , biochemistry , membrane , oxygen , chemistry , organic chemistry , engineering , physics , quantum mechanics , operations research
Although administration of exogenous surfactant to the neonate with RDS often relieves hypoxia rapidly, it is events occurring some 18–48 h later that determine the ultimate clinical outcome, indicating a vital second stage to ‘rescue’. It is proposed that, whereas a reduction in surface tension facilitates the initial penetration of the lungs by air, the second stage is provided by surface‐active phospholipid (SAPL) slowly adsorbing (binding) to alveolar epithelium to displace water in the same way that surfactants are widely used industrially as ‘de‐watering’ agents. In the normal newborn, this de‐watering lining of SAPL is already in place, explaining the extremely rapid expulsion of fluid from the lungs at birth. The selection or formulation of a surfactant for rescue should thus take both stages into consideration.