# Pulmonary surfactants (class) Drug · id `maternal:pulmonary-surfactants` · Maternal & Newborn Atlas · release `c7fb95f1d15a7d13` (public) > General information from published sources, not medical advice, and not reviewed by clinicians. Check the cited source before relying on anything here. The atlas's own text and curation may be reused under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0, https://creativecommons.org/licenses/by-nc/4.0/): credit the atlas, and do not use it commercially. See the atlas About page. Text quoted from a source stays under that source's own terms, given as the source's reuse\_basis. The atlas's reuse terms do not cover it. The downloads list each quotation with its source in third\_party\_quotations. Browse, life stage: Newborn Browse, care area: Preterm and sick newborns ## In plain language Surfactants are medicines that replace the natural lung coating that preterm babies may lack. They are given into the windpipe of a baby with breathing trouble. The SUPPORT trial compared giving surfactant early with starting CPAP, and the 2025 European consensus guidelines advise considering early surfactant through a thin catheter, to try to avoid a breathing tube. ## Technical summary Drug, level class. The label of a surfactant product describes surfactant as lowering surface tension in the air sacs and keeping them from collapsing, and says the product makes up for the deficiency in preterm infants. The class page holds the European consensus claim (an abstract-level statement) and points to SUPPORT, which compared early intubation and surfactant with CPAP started in the delivery room. Claims about one product or substance sit on that product's page, not here. Other surfactant products (Infasurf, Survanta) are not recorded. ## Claims, with the population each applies to ## Context: Preterm babies with respiratory distress (European consensus guidelines on RDS, 2025 edition) Recipient: Newborn; Population: Babies with respiratory distress syndrome, as covered by the seventh version of the European Guidelines for the Management of RDS, written by a panel of European neonatologists and an expert perinatal obstetrician from the literature up to mid-2025. The abstract gives no gestational age or birth weight limits.; Care setting: Delivery room and neonatal care in Europe (panel of European neonatologists); the abstract names no settings.; Geography: Europe (the panel's origin; the abstract names no countries); Life stage: Preterm babies with respiratory distress; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Not applicable (guidance context) ### The 2025 European consensus guidelines on respiratory distress syndrome say that delivery room protocols should include keeping the baby's temperature normal, trying to promote spontaneous breathing before the cord is clamped, using non-invasive respiratory support where possible and considering early surfactant given through a thin catheter in an attempt to avoid intubation. They add that continuing non-invasive support and judicious use of surfactant by techniques that avoid intubation will help improve outcomes. - Category: Recommendation - Evidence stage: Guidance - Certainty: Certainty not assessed - Applies to: Recipient: Newborn; Population: Babies with respiratory distress syndrome, as covered by the seventh version of the European Guidelines for the Management of RDS, written by a panel of European neonatologists and an expert perinatal obstetrician from the literature up to mid-2025. The abstract gives no gestational age or birth weight limits.; Care setting: Delivery room and neonatal care in Europe (panel of European neonatologists); the abstract names no settings.; Geography: Europe (the panel's origin; the abstract names no countries); Life stage: Preterm babies with respiratory distress; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Not applicable (guidance context) - Limitations: Only the PubMed abstract was read. The PMC copy of the guideline is CC BY-NC and was not used; a later 2026 PubMed item with a similar title is a comment with no abstract. The abstract gives no strength of recommendation or certainty grade and no numbers. It says to consider early thin-catheter surfactant, not to give it to every baby. It is a consensus statement of a panel, not a trial. - Last checked: 2026-10-15 - Sources: 1. Supports: European Consensus Guidelines on the Management of Respiratory Distress Syndrome: 2025 (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, sentences 4 and 5. Retrieved 2026-10-15T13:49:21Z. Source state: Current. Snapshot hash: d7ac1165f6c557de74a248cd14b2e816d73b8425613c1517f08c3a4322cc7150. How it applies: Delivery room advice and surfactant technique. 2. Background: European Consensus Guidelines on the Management of Respiratory Distress Syndrome: 2025 (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, sentence 2. Retrieved 2026-10-15T13:49:21Z. Source state: Current. Snapshot hash: d7ac1165f6c557de74a248cd14b2e816d73b8425613c1517f08c3a4322cc7150. How it applies: Who wrote the guideline and the literature cut-off. ## Connected pages - European consensus (2025): consider early surfactant by thin catheter to avoid intubation: Respiratory distress syndrome in preterm babies (`maternal:neonatal-respiratory-distress-syndrome`) [a claim, not a settled fact; see claim `maternal:claim-european-consensus-2025-surfactant` and its context] - Filed under this front: Medicines and vaccines (`maternal:front-medicines-and-vaccines`) - Has subtype: Poractant alfa (`maternal:poractant-alfa`) - Investigated in: SUPPORT trial (CPAP against surfactant; oxygen saturation targets) (`maternal:support-trial`) ## Provenance Content hash: 2b4ebe8fdb34997a48570993f8ef9d532ca0fea8fbd24bc0b3fe6b6c65c311a0 Last substantive edit: 2026-10-15 Evidence last checked: 2026-10-15