Leakage of plasma proteins into the alveoli inhibits pulmonary surfactant function and worsens respiratory failure. Surfactant protein B (SP-B), is essential for surfactant function, but the N-terminal domain of human SP-B (residues 1.25, SP-B 1±25 ) can mimic the biophysical properties of full length SP-B 1±78 in vitro.The authors compared the function and inhibition resistance of synthetic surfactant preparations containing SP-B analogues to a natural bovine surfactant preparation "Survanta TM ".Eight groups of eight rats were lavaged to induce surfactant deficiency, fibrinogen was instilled as a surfactant inhibitor, and then they were rescued with exogenous surfactant. Five experimental surfactants were formulated by mixing 3% SP-B 1±78 , or an equimolar amount of SP-B 1±25 and/or 1% palmitoylated surfactant protein C (SP-C) 1±35 , into a standard phospholipid (PL) mixture: B 1±78 , B 1±25 , C 1±35 , B 1±78 +C 1±35 , and B 1±25 +C 1±35 surfactant preparations. Survanta TM was used as a positive control and PL and no treatment as a negative control. Lung function was assessed during a 2-h period using arterial blood gas and lung compliance measurements.Rats treated with B 1±25 +C 1±35 surfactant and Survanta TM maintained the highest oxygenation and lung compliance values throughout the experiments. The surfactants could be ranked as B 1±25 +C 1±35 surfactant and Survanta TM >B 1±25 and B 1±78 +C 1±35 surfactants >others.