Whilst exogenous surfactant therapy is central to the management of newborn infants with respiratory distress syndrome, its use in other neonatal lung diseases remains inconsistent and controversial. Here we discuss the evidence and experience in relation to surfactant therapy in newborns with other lung conditions in which surfactant may be deficient or dysfunctional, including meconium aspiration syndrome, pneumonia, congenital diaphragmatic hernia and pulmonary haemorrhage. We find that, for all of these diseases, administration of exogenous surfactant as bolus therapy is frequently associated with transient improvement in oxygenation, likely related to temporary mitigation of surfactant inhibition in the airspaces. However, for none of them is there a lasting clinical benefit of surfactant therapy. By virtue of interrupting disease pathogenesis, lavage therapy with dilute surfactant in MAS offers the greatest possibility of a more pronounced therapeutic effect, but this has yet to be definitively proven. Lavage therapy also involves a greater degree of procedural risk.

虽然外源性表面活性剂治疗对于患有呼吸窘迫综合征的新生儿的治疗至关重要，但其在其他新生儿肺部疾病中的应用仍然不一致且存在争议。在这里，我们讨论与表面活性剂治疗有关的证据和经验，以治疗患有其他肺部疾病的新生儿，其中表面活性剂可能缺乏或功能障碍，包括胎粪吸入综合征、肺炎、先天性膈疝和肺出血。我们发现，对于所有这些疾病，外源性表面活性剂作为推注疗法的施用通常与氧合作用的短暂改善有关，可能与空腔中表面活性剂抑制的暂时缓解有关。然而，对于他们来说，表面活性剂疗法都没有持久的临床益处。由于阻断疾病的发病机制，MAS中稀释的表面活性剂灌洗疗法最有可能获得更显着的治疗效果，但这一点尚未得到明确证实。灌洗疗法还涉及更大程度的手术风险。