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Bolus surfactant instillation has been described as a possible treatment by several authors in uncontrolled clinical trials. The efficacy of the method has not been unanimously accepted due to the presence of meconium in the airways and the possibility to deteriorate the lung patency by instilling a cremous liquid (surfactant). Moreover, surfactant administered can be rapidly inactivated by the large quantity of existing meconium.
Halliday et al. have demonstrated that the treatment may be useful in some specific conditions. The variety of lung damage (obstruction, chemical pneumonia, production of large quantities of inhibitors) may be determinant in the final result of surfactant supplementation.
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