Respiratory distress syndrome (RDS) is a very serious and life-threatening medical condition in which the lungs are unable to provide enough oxygen for the rest of the body. Without treatment, respiratory distress syndrome is fatal.
Table of Contents
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Types
- Neonatal respiratory distress syndrome (NRDS) (hyaline membrane disease)
- Acute respiratory distress syndrome (ARDS)
Causes of Respiratory distress syndrome
Neonatal Respiratory Distress Syndrome (NRDS)
- The lungs of premature infants lack surfactant
- Genetic problems with lung development
- Brother or sister who had RDS
- Diabetes in the mother
- Cesarean delivery
- Delivery complications leading to acidosis in the newborn at birth
- Multiple pregnancies (twins or more)
- Rapid labour
Acute Respiratory Distress Syndrome (ARDS)
- Acute pancreatitis
- Aspiration
- Bacterial and fungal pneumonia
- Drug overdose
- Injury to the chest
- Multiple fractures, Fracture of the long bones
- Near drowning
- Sepsis
- Severe head injury
- Toxic inhalations
- Transfusion of multiple units of blood
- Viral pneumonia
Symptoms and signs
Neonatal Respiratory Distress Syndrome
- A grunting sound when breathing
- Blue-coloured lips, fingers and toes
- Decreased urine output
- Flaring nostrils
- Grunting
- Puffy or swollen arms or legs
- Rapid, shallow breathing
- The skin around the ribs and chest appear pulled in, making the bones of the ribs and chest easily visible.
Acute Respiratory Distress Syndrome
- Agitation
- Anxiety
- Blue-coloured lips, fingers and toes
- Fever
- Increasingly laboured and difficult breathing
- Rapid heartbeat
- Rapid, shallow breathing
- Tiredness followed by drowsiness or confusion.
Investigations
NRDS
- Blood test (gas analysis)
- Pulse oximetry test
- X-ray
- Echocardiogram
ARDS
- Blood test
- Arterial blood gas
- complete blood count
- Chest x-ray
- CT scan
- Echocardiogram
- Bronchoscopy
Treatment
NRDS
- Surfactant Replacement Therapy
Surfactant usually is given through a breathing tube that’s attached to a bag to help push the surfactant directly into the baby’s lungs.
- Breathing Support or nasal continuous positive airway pressure (NCPAP).
- Oxygen Therapy
- Medicines(antibiotics)
- Supportive Therapy
Treatment in the NICU is designed to limit stress on babies and meet their basic needs of warmth, nutrition, and protection.
ARDS
- Oxygen Therapy
- Ventilator
- Tracheotomy
- Fluids
- Medicines
Complications
Neonatal RDS
- Atelectasis
- Blindness
- Bronchopulmonary dysplasia
- Haemorrhage
- Kidney failure
- Mental retardation/cerebral palsy.
- Necrotizing enterocolitis
- Patent ductus arteriosus(PDA)
- Pneumothorax
- Sepsis
Acute RDS
- Multiple organ system failures
- Pneumothorax
- Pulmonary fibrosis
- ventilator-associated pneumonia
Prevention
Neonatal RDS
- Regular ante-natal check-ups
- Healthy diet
- Avoiding tobacco smoke, alcohol, and illegal drugs
- Controlling any ongoing medical conditions you have
- Preventing infection
Acute RDS
Taking appropriate measures to prevent aspiration( eg. elevation of the head of the bed),