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Surfactant is the detergent-like substance in the lungs that dramatically lowers the surface tension of the fluid normally present within the air sacs. If this substance is not present in adequate amounts - as is often the case with premature newborns or rarely even in stressed term babies - the air sacs tend to collapse. In this state, air exchange cannot occur, and the baby suffers great difficulty getting enough oxygen to the bloodstream. Lack of adequate surfactant is thus the cause of what used to be called hyaline membrane disease, or now more properly respiratory distress syndrome type I (RDS). Adults can suffer loss of surfactant during periods of great stress, so-called adult respiratory distress syndrome, or "shock lung."
Treatment of surfactant deficit has been revolutionized in recent years by the development of artificially supplied surfactant (harvested from cow lungs).