Respiratory Distress Syndrome

(Newborn)
Respiratory Distress Syndrome

 Respiratory distress syndrome (hyaline
membrane disease) is a breathing disorder
of premature newborns in which the air sacs
(alveoli) in a newborn's lungs do not remain
open because the production of a substance
that coats the alveoli (surfactant) is absent
or insufficient.

 Neonatal RDS occurs in infants whose lungs have not yet
fully developed.
 The disease is mainly caused by a lack of a slippery,
protective substance called surfactant, which helps the
lungs inflate with air and keeps the air sacs from
collapsing. This substance normally appears in mature
lungs.
 It can also be the result of genetic problems with lung
development.
 The earlier a baby is born, the less developed the lungs
are and the higher the chance of neonatal RDS. Most
cases are seen in babies born before 28 weeks. It is
very uncommon in infants born full-term (at 40 weeks).
following increase the risk of
neonatal RDS:


A brother or sister who had RDS
 Diabetes in the mother
 Cesarean delivery
 Delivery complications that lead to acidosis in the
newborn at birth
 Multiple pregnancy (twins or more)
 Rapid labor
 The risk of neontal RDS may be decreased if the
pregnant mother has chronic, pregnancy-related
high blood pressure or prolonged rupture of
membranes, because the stress of these
situations cause the infant's lungs to mature
sooner.

Symptoms
 The symptoms usually appear within minutes of birth,
although they may not be seen for several hours.
Symptoms may include:
 Bluish color of the skin and mucus membranes (cyanosis)
 Brief stop in breathing (apnea)
 Decreased urine output
 Grunting
 Nasal flaring
 Puffy or swollen arms or legs
 Rapid breathing
 Shallow breathing
 Shortness of breath and grunting sounds while breathing
 Unusual breathing movement -- drawing back of the chest
muscles with breathing

Exams and Tests

A blood gas analysis shows low oxygen and excess
acid in the body fluids.
 A chest x-ray shows respiratory distress. The lungs
have a characteristic "ground glass" appearance,
which often develops 6 to 12 hours after birth.
Lung function studies may be needed.
 Lab tests are done to rule out infection and sepsis
as a cause of the respiratory distress.

Treatment
 High-risk and premature infants require prompt
attention by a neonatal resuscitation team.
 Despite greatly improved RDS treatment in recent
years, many controversies still exist. Delivering
artificial surfactant directly to the infant's lungs
can be enormously important, but how much
should be given and who should receive it and
when is still under investigation.
 Infants will be given warm, moist oxygen. This is
critically important, but needs to be given
carefully to reduce the side effects associated
with too much oxygen.


A breathing machine can be lifesaving, especially
for babies with the following:


 Highlevels of carbon dioxide in the arteries

 Low blood oxygen in the arteries
 Low blood pH (acidity)

A treatment called continuous positive airway pressure
(CPAP) that delivers slightly pressurized air through the
nose can help keep the airways open and may prevent
the need for a breathing machine for many babies.
Even with CPAP, oxygen and pressure will be reduced as
soon as possible to prevent side effects associated with
excessive oxygen or pressure.


A variety of other treatments may be used, including:



 Extracorporeal membrane oxygenation (ECMO) to directly

put oxygen in the blood if a breathing machine can't be
used
 Inhaled nitric oxide to improve oxygen levels

 Itis important that all babies with RDS receive
excellent supportive care, including the
following, which help reduce the infant's
oxygen needs:
 Few disturbances
 Gentle handling
 Maintaining ideal body temperature
 Infants with RDS also need careful fluid
management and close attention to other
situations, such as infections, if they
develop.

 QUESTIONS:
 1. What does HIV stands for?
 2. How do newborn babies get HIV?
 3. Respiratory Distress Syndrome also known as?
 4. What does CPAP stands for
 5. Give 1 preventive tip to prevent SIDS?
 6. T or F- Is it ok for a HIV mother to breastfeed her baby?
 7. State one common test performed on premature infant
 8.State one different pregnancy related problems that
increases the risk of preterm labor.
 9. Give 1 risk for developing Transient Tachypnea of the
Newborn.
 10. State the reason why there is a need to give Vitamin K
to newborn babies.
