The role of pulmonary surfactant in the pathogenesis of bronchopulmonary diseases and the prospects of surfactant therapy in COVID-19

The current understanding of the main functions of surfactant, data on its composition, and its role in dysfunction and pathogenesis of bronchopulmonary pathology are discussed. The paper presents new information about the results and prospects of surfactant therapy for bronchopulmonary pathology. The use of surfactant in acute respiratory distress syndrome (ARDS) in adults has been studied. An analysis of the composition of commercial drug products is conducted, and the current experience of replacement therapy with the exogenous surfactant preparation Surfactant-BL in infection caused by the SARS-CoV-2 virus (COVID-19) is provided. Personal experience in the use of the drug Surfactant-BL for treating patients with COVID-19 infection in real clinical practice is also presented using the example of 8 individuals. All patients (male and female) were over 18 years old, had a confirmed diagnosis of COVID-19, showed changes on chest CT scans (CT-2+), were undergoing oxygen therapy by any method, and had CRP > 30 mg/L. Surfactant-BL was administered to all patients as an inhaled emulsion at doses of 75-150 mg. An increase in oxygen saturation was observed in 1 (12.5%) patient 1 day after inhalation of the drug Surfactant-BL, in 4 (50%) patients on the 2 nd day, and in 3 (12.5%) patients on the 7 th day. The average duration of oxygen therapy was 4 days, and mechanical ventilation was 7 days. The average hospital stay of the patients was 25 days, which was reduced to 20 days after the use of Surfactant-B L. The drug Surfactant-BL demonstrated effectiveness; however, further research is needed as the authors have a limited number of cases studied.