Department of Physiology & Pharmacology, Western University, London, Ontario, Canada.
Department of Medicine, Western University, London, Ontario, Canada.
Expert Rev Respir Med. 2021 May;15(5):597-608. doi: 10.1080/17476348.2021.1865809. Epub 2020 Dec 28.
The dramatic impact of COVID-19 on humans worldwide has initiated an extraordinary search for effective treatment approaches. One of these is the administration of exogenous surfactant, which is being tested in ongoing clinical trials.
Exogenous surfactant is a life-saving treatment for premature infants with neonatal respiratory distress syndrome. This treatment has also been tested for acute respiratory distress syndrome (ARDS) with limited success possibly due to the complexity of that syndrome. The 60-year history of successes and failures associated with surfactant therapy distinguishes it from many other treatments currently being tested for COVID-19 and provides the opportunity to discuss the factors that may influence the success of this therapy.
Clinical data provide a strong rationale for using exogenous surfactant in COVID-19 patients. Success of this therapy may be influenced by the mechanical ventilation strategy, the timing of treatment, the doses delivered, the method of delivery and the preparations utilized. In addition, future development of enhanced preparations may improve this treatment approach. Overall, results from ongoing trials may not only provide data to indicate if this therapy is effective for COVID-19 patients, but also lead to further scientific understanding and improved treatment strategies.
COVID-19 对全球人类的巨大影响，引发了人们对有效治疗方法的探索。其中之一是外源性表面活性剂的应用，目前正在进行临床试验。
外源性表面活性剂是治疗新生儿呼吸窘迫综合征早产儿的救命疗法。该治疗方法也在急性呼吸窘迫综合征（ARDS）中进行了测试，但效果有限，这可能是由于该综合征的复杂性所致。表面活性剂治疗 60 年的成功和失败经验使其有别于目前正在为 COVID-19 测试的许多其他治疗方法，并提供了一个讨论可能影响该治疗成功的因素的机会。
临床数据为 COVID-19 患者使用外源性表面活性剂提供了强有力的依据。该疗法的成功可能受到机械通气策略、治疗时机、给予的剂量、给予的方法和所用制剂的影响。此外，增强制剂的未来发展可能会改进这种治疗方法。总的来说，正在进行的试验结果不仅可以提供数据，表明该疗法对 COVID-19 患者是否有效，而且还可以促进进一步的科学理解和改进治疗策略。
