Lung surfactants for replacement therapy: biochemical, biophysical, and clinical aspects.

This article characterizes and analyzes current concepts of the pulmonary surfactant system, and its actions and importance in respiration. Much of the discussion concerns the fundamental role of lung surfactant in the respiratory distress syndrome (RDS) of premature infants, and the success of exogenous surfactant replacement in clinical therapy for this disease. In addition, basic descriptions of the biophysical and physiological activity of lung surfactant are provided to define mechanisms behind surfactant replacement therapy, and how it might be optimized by the further development of appropriate synthetic lung surfactant substitutes.