Surfactant use in late preterm infants with respiratory distress: benefits and controversies

Abstract Exogenous surfactant is the treatment of choice for hyaline membrane disease in extremely preterm neonates, but its use in late preterm infants remains controversial. Respiratory distress in this group may be related to partial surfactant deficiency and an exacerbated inflammatory response. Early administration of surfactant has shown benefits in reducing the need for mechanical ventilation and decreasing respiratory morbidity. However, the lack of standardized criteria for its indication in late preterm infants limits its widespread implementation. This review analyzes the current evidence on the efficacy of surfactant in this subgroup of neonates and discusses the challenges in optimizing its clinical use. Keywords: Surfactant, prematurity, respiratory distress, neonatology.