Respiratory distress syndrome (RDS) is most important cause of morbidity and mortality in preterm infants. Treatment modalities for RDS are surfactant replacement therapy (SRT), supplemental oxygen, nasopharyngeal continuous positive airway pressure (NP-CPAP) and mechanical ventilation. Surfactant is a life saving drug for infants with RDS but the cost of this therapy is still relatively high. Although surfactant has now became a standard of care in the management of RDS, still there are various critical issues which are to be settled regarding its mode or timing of administration, dose and type of surfactant to be used, use in conditions other than RDS and cost effectiveness. In scenario of countries like ours where the bruden of prematurity is increasing with improvements in high risk obstetrics case management. In the face of limited resources these issues of surfactant replacement therapy become more challenging. There is paucity of published literature from our country. These issues need to be undertaken for research in the country so than it can be tailored in best and most efficient way.
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