Surfactant replacement therapy (SRT) has revolutionized the management of respiratory distress syndrome (RDS) in premature infants, leading to improved survival rates and decreased morbidity. SRT may, however, be associated with hemodynamic changes, which can have both positive and negative effects on the immature cardiovascular system, during the transitional adaptation from fetal to extrauterine environment. However, there is a relative paucity of evidence in this domain, with most of them derived from small heterogeneous observational studies providing conflicting results.

In this review, we will discuss the hemodynamic changes that occur with surfactant administration during this vulnerable period, focusing on available evidence regarding changes in pulmonary and systemic blood flow, cerebral circulation and their clinical implications.

表面活性剂替代疗法 (SRT) 彻底改变了早产儿呼吸窘迫综合征 (RDS) 的治疗，从而提高了存活率并降低了发病率。然而，SRT 可能与血流动力学变化有关，在胎儿向宫外环境的过渡适应过程中，血流动力学变化可能对不成熟的心血管系统产生积极和消极的影响。然而，该领域的证据相对缺乏，其中大多数来自小型异质观察研究，提供了相互矛盾的结果。

在这篇综述中，我们将讨论在这个脆弱时期使用表面活性剂所发生的血流动力学变化，重点关注有关肺和全身血流、脑循环变化及其临床意义的现有证据。