Surfactant in the perinatal period.

Surfactant is now available for general clinical use in infants with RDS. While surfactant is effective, it does not prevent lung disease in many preterm infants because of other aspects of lung immaturity. In experimental models, corticosteroids alter the fetal lung by improving compliances, increasing lung volumes, decreasing pulmonary edema, and altering surfactant-compliance dose response curves. These effects are independent of changes in surfactant pools but augment the responses of the lungs to surfactant treatment. Optimal outcomes for the preterm require the combined use of fetal maturation strategies and postnatal surfactant.