The clinical course and outcomes of cases of acute respiratory distress syndrome (ARDS) as evolved after open-heart surgeries under the conditions of traditional treatment and under the conditions of using the exogenous surfactant drug were comparatively analyzed. A reliably improved oxygenation was registered in the 1st group patients (18 subjects), who received surfactant, yet 24 hours later; while the identical improvement was noted in the 2nd group patients (19 subjects) only in 98 hours. The possibility of respiratory support with FiO2 below 45% was ensured in 15 (83.3%) patients of group 1 and in 10 (52.6%) patients of group 2. Thirteen (72.2%) patients in the 1st group and 9 (47.4%) patients in the 2nd group were transferred to independent breathing. The lethality rate in ARDS with the surfactant therapy made up 33.3%, it was 52.6% in traditional treatment.