Infant respiratory distress syndrome
Infant respiratory distress syndrome Causes
The biggest risk factor for RDS is prematurity. Other risk factors include maternal diabetes, cesarean delivery, and asphyxia. Not all premature infants end up developing RDS.
Infant respiratory distress syndrome Definition
Infant respiratory distress syndrome ("RDS", also known as "Respiratory distress syndrome of newborn", previously called hyaline membrane disease), is a syndrome caused in premature infants by developmental insufficiency of surfactant production and structural immaturity in the lungs. It can also arise from a genetic problem with the production of surfactant associated proteins. RDS affects around 1% of newborn infants and is the leading cause of death in preterm infants.
Infant respiratory distress syndrome Diagnosis
The diagnosis is done by the clinical picture and the chest xray, which demonstrates decreased lung volumes (bell-shaped chest), absence of the thymus (after about 6 hours), a small (0.5-1 mm), discrete, uniform infiltrate (sometimes described as a "ground glass" appearance) that involves all lobes of the lung, and air-bronchograms (ie the infiltrate will outline the larger airways passages which remain air-filled). In extreme cases, this becomes exaggerated until the cardiac borders become inapparent (a 'white-out' appearance).
Infant respiratory distress syndrome Symptoms and Signs
Respiratory distress syndrome starts shortly after birth and is manifest by tachypnea, tachycardia, chest wall retractions (recession), expiratory grunting, flaring of the nostrils and cyanosis during breathing efforts.
Infant respiratory distress syndrome Treatment
Oxygen is given with a minute amount of continuous positive airway pressure ("CPAP"), and intravenous fluids are administered to stabilize the blood sugar, blood salts, and blood pressure. If the baby's condition becomes worse, an endotracheal tube (breathing tube) is inserted into the trachea and intermittent breaths are given by a mechanical device. An exogenous preparation of surfactant, either synthetic or extracted from animal lungs, is given via the breathing tube into the lungs.