Respiratory distress syndrome

Respiratory Distress Syndrome

Respiratory Distress Syndrome (RDS), also known as Hyaline Membrane Disease, is a medical condition that occurs in newborns, primarily affecting premature infants. It is characterized by insufficient surfactant production in the lungs, leading to difficulty in breathing and inadequate oxygenation of the blood.

Pathophysiology

Surfactant is a substance produced by the alveoli in the lungs that reduces surface tension, preventing the collapse of the alveoli during exhalation. In infants with RDS, the lack of surfactant leads to the collapse of the alveoli, resulting in impaired gas exchange and respiratory failure. This condition is most common in infants born before 37 weeks of gestation.

Symptoms

The symptoms of RDS typically appear within minutes to hours after birth and may include:

• Rapid, shallow breathing (tachypnea)
• Grunting sounds during exhalation
• Flaring of the nostrils
• Cyanosis (bluish color of the skin due to lack of oxygen)
• Chest retractions (pulling in of the chest muscles during breathing)

Diagnosis

RDS is diagnosed based on clinical presentation and diagnostic tests, including:

• Chest X-ray: Shows a characteristic "ground glass" appearance and air bronchograms.
• Blood gas analysis: Indicates low oxygen levels and acidosis.

Treatment

The primary treatment for RDS involves supportive care and interventions to improve lung function, including:

• Administration of exogenous surfactant: Delivered directly into the infant's lungs via an endotracheal tube.
• Mechanical ventilation: Provides respiratory support to maintain adequate oxygenation and ventilation.
• Continuous positive airway pressure (CPAP): Helps keep the alveoli open and reduces the work of breathing.

Prevention

Preventive measures for RDS include:

• Administration of antenatal corticosteroids to pregnant women at risk of preterm delivery: Stimulates fetal lung maturation and surfactant production.
• Delayed cord clamping: Increases blood volume and improves lung function in preterm infants.

Prognosis

With advances in neonatal care, the prognosis for infants with RDS has significantly improved. However, complications such as bronchopulmonary dysplasia and intraventricular hemorrhage may still occur, particularly in extremely premature infants.

Related Pages

• Premature birth
• Neonatal intensive care unit
• Bronchopulmonary dysplasia
• Intraventricular hemorrhage
• Continuous positive airway pressure
• Mechanical ventilation