A patient with ARDS may benefit most from which medication to decrease alveolar surface tension?

The correct choice is exogenous surfactant, as it plays a crucial role in improving lung function in patients with Acute Respiratory Distress Syndrome (ARDS) by reducing alveolar surface tension. In ARDS, the alveoli can collapse due to decreased surfactant production or function, leading to impaired gas exchange. Administering exogenous surfactant helps restore the surface tension balance, promoting alveolar stability and improving lung compliance. This results in better ventilation and oxygenation for the patient.

Other medication combinations, while they may have their uses in managing different respiratory conditions, do not directly address the problem of surface tension in the alveoli. Spiriva, a bronchodilator, and decadron, a corticosteroid, may help in reducing airway inflammation but do not provide the surfactant needed to effectively lower surface tension in the alveoli. Tobramycin, an antibiotic, and albuterol, a bronchodilator, can aid in treating infections or bronchospasm, but they also do not tackle the underlying surfactant deficiency. Cromolyn sodium is a mast cell stabilizer and is used primarily for allergic reactions or asthma, not for surfactant replacement in ARDS conditions.