Infant respiratory distress syndrome

Infantile Respiratory Distress Syndrome (IRDS)

Micrograph showing the features of Hyaline Membrane Disease, a previous name for IRDS

Infantile Respiratory Distress Syndrome (IRDS), also known as respiratory distress syndrome of newborns or surfactant deficiency disorder (SDD), is a serious condition affecting premature infants. It results from insufficient production of pulmonary surfactant and structural immaturity in the lungs.

Definition and Overview

IRDS, formerly known as hyaline membrane disease (HMD), is primarily seen in premature infants. The syndrome is characterized by difficulty in breathing, resulting from the lack of surfactant, a fluid that helps the lungs stay open and reduces surface tension in the alveoli.

Pathophysiology

The primary cause of IRDS is the underdevelopment of the lungs, particularly the lack of surfactant. Surfactant is essential for reducing surface tension within the alveoli and for keeping the lungs expanded.

Surfactant Insufficiency

• Lack of surfactant leads to alveolar collapse
• Results in compromised oxygen exchange

Lung Immaturity

• Structural immaturity in the lungs of premature infants
• Inability to maintain effective gas exchange

Clinical Manifestations

Symptoms of IRDS typically appear shortly after birth and may include:

• Rapid, shallow breathing
• Nasal flaring
• Chest wall retractions
• Grunting sounds
• Cyanosis (bluish skin color)

Diagnosis

Diagnosis of IRDS is based on:

• Clinical presentation
• Chest X-ray findings
• Blood gas analysis

Treatment and Management

Treatment of IRDS focuses on supporting the infant’s breathing and may include:

• Administration of supplemental oxygen
• Mechanical ventilation
• Surfactant replacement therapy
• Supportive care in a neonatal intensive care unit (NICU)

Epidemiology and Risk Factors

IRDS affects approximately 1% of newborns. Factors increasing the risk include:

• Prematurity
• Elective caesarean sections, which can increase incidence in term infants
• Genetic factors affecting surfactant production

Prevention and Prognosis

Preventive measures include:

• Administration of corticosteroids to the mother before preterm delivery
• Delaying elective caesarean sections until after 39 weeks of gestation
• The prognosis has improved significantly with advances in neonatal care.

Historical Perspective

Historically termed as hyaline membrane disease, the understanding and management of IRDS have evolved over the years, particularly with the development of surfactant therapy in the late 20th century.

References

Infant respiratory distress syndrome Resources
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