Surfactant is a complex surface-active substance, consisting of lipids and proteins, which lines the surface of terminal bronchioles and alveoli of mammalian lungs. It is responsible for maintaining essential biophysical and immunological functions of the lungs. Surfactant impairment is common in many pathological situations, leading to deterioration of pulmonary function. These facts have been known for about 50 years and since then we have been trying to develop effective treatment based on a natural or synthetic surfactant. In clinical practice, the use of surfactant has been well established only in newborns. In adults, the greatest experience with surfactant treatment has been gained in patients with acute respiratory distress syndrome (ARDS), the results however, being controversial. Recently new, narrower indications for surfactant use have emerged, bringing the first promising results.

        Key words: surfactant – ARDS