How should surfactant therapy be administered to a preterm neonate with IRDS?

Surfactant therapy is a critical intervention for preterm neonates diagnosed with infant respiratory distress syndrome (IRDS), primarily due to surfactant deficiency in their lungs. Administering surfactant directly into the trachea via endotracheal instillation is the most effective method. This approach allows the surfactant to be deposited directly into the alveoli, where it can immediately reduce surface tension, improve lung compliance, and enhance gas exchange.

Using endotracheal instillation maximizes the surface area coverage of the surfactant on the alveolar walls, which is crucial for neonates who may have collapsed alveoli (atelectasis), a common issue in IRDS. This method ensures that the surfactant reaches the most affected areas of the lungs, thus facilitating improved pulmonary function and oxygenation for the infant.

In contrast, alternative methods like nebulizers or dry powder inhalers are not suitable for delivering surfactant to neonates. These methods do not allow for the immediate and direct administration necessary to effectively manage IRDS, as they are typically designed for aerosolized medication delivery rather than the administration of liquid surfactants. Nasopharyngeal instillation is also not a viable method for surfactant delivery