Use of pulmonary surfactant in neonatal respiratory distress syndrome: an integrative review

Abstract

Respiratory Distress Syndrome (RDS) is one of the leading causes of morbidity and mortality in premature newborns, being associated with quantitative and functional deficiency of pulmonary surfactant due to pulmonary immaturity. In this context, exogenous surfactant represents one of the main therapeutic strategies for the management of neonatal RDS. This study aimed to analyze the scientific evidence regarding the clinical impacts of using pulmonary surfactant in premature newborns with RDS and its implications for nursing care. This is an integrative literature review, conducted in the Virtual Health Library (VHL) and Scientific Electronic Library Online (SciELO) databases, using the descriptors "pulmonary surfactant," "prematurity," "respiratory distress syndrome," and "nursing," combined with Boolean operators. Studies published between 2020 and 2025, available in full text in Portuguese, were included. After applying the eligibility criteria, the final sample consisted of 10 studies. The results showed that surfactant administration promotes improved oxygenation, increased pulmonary compliance, reduced need for invasive mechanical ventilation, and decreased neonatal morbidity and mortality. It was also observed that early surfactant administration, especially using minimally invasive techniques such as LISA and MIST, is associated with better clinical outcomes. In the nursing context, continuous monitoring of the newborn, prevention of complications, implementation of the Nursing Care Systematization, and support for the family during hospitalization were highlighted. It is concluded that pulmonary surfactant remains one of the therapeutic pillars in the treatment of neonatal RDS, contributing significantly to the improvement of clinical outcomes. The qualified performance of the multidisciplinary team and nursing staff is fundamental to ensuring safe, humanized, and evidence-based care.