{
  "release_id": "c7fb95f1d15a7d13",
  "id": "maternal:pulmonary-surfactants",
  "owner": "maternal",
  "kind": "drug",
  "slug": "pulmonary-surfactants",
  "name": "Pulmonary surfactants (class)",
  "aliases": [],
  "atlases": [
    "maternal"
  ],
  "summary_plain": "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.",
  "summary_technical": "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.",
  "editorial_state": "draft",
  "last_substantive_edit": "2026-10-15",
  "last_evidence_check": "2026-10-15",
  "next_review_due": null,
  "identifiers": [],
  "navigation": {
    "maternal": {
      "life-stage": [
        "newborn"
      ],
      "care-area": [
        "preterm-and-sick-newborn"
      ]
    }
  },
  "payload": {
    "level": "class",
    "mechanism": "Replaces deficient natural pulmonary surfactant, which lowers surface tension in the air sacs and keeps them from collapsing (a surfactant product label)."
  },
  "content_digest": "2b4ebe8fdb34997a48570993f8ef9d532ca0fea8fbd24bc0b3fe6b6c65c311a0",
  "review": {
    "content_digest": "2b4ebe8fdb34997a48570993f8ef9d532ca0fea8fbd24bc0b3fe6b6c65c311a0",
    "current": [],
    "conflicting": [],
    "stale": [],
    "inactive": []
  },
  "claims": [
    {
      "release_id": "c7fb95f1d15a7d13",
      "id": "maternal:claim-european-consensus-2025-surfactant",
      "owner": "maternal",
      "subject_entity_id": "maternal:pulmonary-surfactants",
      "category": "recommendation",
      "statement": "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.",
      "context": {
        "id": "maternal:ctx-european-consensus-rds-preterm",
        "label": "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_note": "Preterm babies with respiratory distress",
        "life_stage_terms": {
          "maternal": [
            "newborn"
          ]
        },
        "gestational_age_min_days": null,
        "gestational_age_max_days": null,
        "gestational_age_basis": null,
        "postnatal_age_min_days": null,
        "postnatal_age_max_days": null,
        "gestational_age_status": null,
        "postnatal_age_status": null,
        "followup_description": "Not applicable (guidance context)",
        "eligibility": {
          "inclusion": [
            "Babies with respiratory distress syndrome"
          ],
          "exclusion": []
        }
      },
      "evidence_stage": "guidance",
      "certainty": "not_assessed",
      "certainty_method": null,
      "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.",
      "editorial_state": "draft",
      "checked_at": "2026-10-15",
      "next_review_due": null,
      "valid_from": null,
      "valid_to": null,
      "citations": [
        {
          "evidence_role": "supports",
          "locator": "Abstract, sentences 4 and 5",
          "applicability_note": "Delivery room advice and surfactant technique.",
          "snapshot": {
            "id": "maternal:pubmed-41802129-2026-10-15",
            "retrieved_at": "2026-10-15T13:49:21Z",
            "content_hash": "d7ac1165f6c557de74a248cd14b2e816d73b8425613c1517f08c3a4322cc7150",
            "source_effective_date": null,
            "public_archive_url": null,
            "source_state": "current"
          },
          "source": {
            "id": "maternal:pubmed-10-1159-000551062",
            "source_type": "publication",
            "title": "European Consensus Guidelines on the Management of Respiratory Distress Syndrome: 2025",
            "canonical_url": "https://doi.org/10.1159/000551062",
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              },
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              {
                "scheme": "pmcid",
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                "label": null,
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              }
            ],
            "publication_date": "2026-03-09",
            "publisher": "Neonatology",
            "edition": "PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.",
            "reuse_basis": "PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.",
            "public_text": "quote"
          }
        },
        {
          "evidence_role": "context",
          "locator": "Abstract, sentence 2",
          "applicability_note": "Who wrote the guideline and the literature cut-off.",
          "snapshot": {
            "id": "maternal:pubmed-41802129-2026-10-15",
            "retrieved_at": "2026-10-15T13:49:21Z",
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            "source_effective_date": null,
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            "source_state": "current"
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          "source": {
            "id": "maternal:pubmed-10-1159-000551062",
            "source_type": "publication",
            "title": "European Consensus Guidelines on the Management of Respiratory Distress Syndrome: 2025",
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            ],
            "publication_date": "2026-03-09",
            "publisher": "Neonatology",
            "edition": "PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.",
            "reuse_basis": "PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.",
            "public_text": "quote"
          }
        }
      ],
      "review": {
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        "current": [],
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        "inactive": []
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      "api_path": "api/v1/claims/maternal--claim-european-consensus-2025-surfactant.json"
    }
  ],
  "decisions": [],
  "milestones": [],
  "relationships": {
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  "page_path": "drugs/pulmonary-surfactants/",
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}