Exogenous surfactant therapy would be most appropriate for a neonate with which condition?

• A. Infant respiratory distress syndrome
• B. Coarctation of the aorta
• C. Bronchopulmonary dysplasia
• D. Pulmonary interstitial emphysema

Answer: (A)

The key idea is that exogenous surfactant addresses a deficiency of natural surfactant in the lungs, which is the central problem in neonatal respiratory distress syndrome. When a preterm infant lacks enough surfactant, alveoli collapse or fail to stay open, making breathing and gas exchange very hard. Surfactant lowers surface tension inside the alveoli, helps keep them open, improves lung compliance, and reduces the work of breathing. Giving surfactant from outside the lungs rapidly improves oxygenation and ventilation in infants with RDS, making it the most appropriate therapy for a neonate with this condition.

Coarctation of the aorta is a heart defect, so surfactant won’t address the underlying circulation problem. Bronchopulmonary dysplasia is a chronic lung condition often related to prolonged ventilation and oxygen exposure; while early surfactant may help prevent injury, it’s not the primary treatment for established BPD. Pulmonary interstitial emphysema involves air leakage into the lung tissue and is managed with protective ventilation strategies and supportive care rather than surfactant replacement.