PEG enhance performance of lung surfactant
ARDS is characterized by surfactant dysfunction (Baudouin, 2004). Enhancing surfactant performance could reduce COVID-19-ARDS-induced injury. PEG, while not surface active itself, enhances the surface activity of pulmonary surfactant (Yu et al., 2004). Yu, et al. suggest that high molecular weight PEG (8000 to 35,000) bind to phospholipid vesicles and enhance the rate of surface film formation (Yu et al., 2004). PEG reduces inactivation of surfactant and enhances rates of surfactant transfer from bulk lipid to air liquid surfaces (Yu et al., 2004, Taeusch et al., 2008). Research findings by Taeusch, et al. demonstrated that PEG can reverse inactivation of surfactant by meconium and other substances (William Taeusch et al., 1999). Moreover, it has been shown that PEG promotes surfactant aggregation, separates surfactant from surfactant inhibitors, and enhances access of surfactant to the gas–liquid interface (Lu et al., 2001). Taking together, we hypothesize that PEG administration could protect the lung through enhancing the performance of endogenous surfactant.