What therapy should be recommended for an infant with an L/S ratio less than 2:1?

The recommended therapy for an infant with a lecithin/sphingomyelin (L/S) ratio less than 2:1 is surfactant replacement therapy. This ratio is an indicator of the maturity of the fetal lungs; a lower ratio signifies an increased risk of respiratory distress syndrome (RDS) due to immature lung development and insufficient surfactant production.

Surfactant is a substance that reduces surface tension in the alveoli, allowing them to stay open and facilitating easier breathing. In infants, especially those born prematurely, the lack of adequate surfactant can lead to collapsed alveoli, reduced lung compliance, and significant respiratory distress. Therefore, administering surfactant directly improves lung function and can significantly enhance oxygenation, reduce the severity of respiratory distress, and decrease the need for mechanical ventilation.

While other therapies like oxygen therapy may be necessary for managing hypoxia, they do not address the underlying issue of insufficient surfactant. Similarly, intravenous fluids and antibiotics are important in certain clinical contexts but do not resolve the fundamental problem related to respiratory issues due to inadequate surfactant. In summary, surfactant replacement therapy directly targets the cause of RDS in infants with a low L/S ratio, making it the crucial intervention in this