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A newborn delivered at 33 weeks of gestation has a respiratory rate of 70/min. a...

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A newborn delivered at 33 weeks of gestation has a respiratory rate of 70/min. and heart rate of 148/min. 2 hours after birth. He is

grunting and has intercostal and subcostal reiractions. He has peripheral cyanosis as well. An immediate chest radiograph is taken which

shows a fine reticular granulation with ground glass opacity on both lungs. A neonatologist suggests respiratory distress syndrome due

to surfactant deficiency. Which of the following is the most likely mechanism of these clinical and imaging finding?

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