ABSTRACT
The widespread incidence and clinical severity of ARDS have led to significant interest in new therapies aimed at this complex lung injury syndrome. Exogenous surfactant replacement therapy is one such intervention. Lung surfactant dysfunction contributes to the pathology of ARDS, and lung surfactant can also be deficient if type II cell function is impaired. Biophysical and animal model research shows that lung surfactant dysfunction as well as deficiency can be reversed by exogenous supplementation with surfactants able to resist inactivation. This chapter summarizes the conceptual basis and current status of clinical exogenous surfactant therapy for ARDS-related respiratory failure. Also discussed are selected additional agents and interventions that address other aspects of acute lung injury and have the potential to be additive or synergistic if used in conjunction with exogenous surfactant in “multimodal” therapies for ARDS.
