Respiratory Distress Syndrome

Respiratory distress syndrome 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.

Types —

  • Neonatal respiratory distress syndrome (hyaline membrane disease)
  • Acute respiratory distress syndrome (ARDS)

Causes—

Neonatal Respiratory Distress Syndrome (NRDS)

  • 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 pregnancy (twins or more)
  • Rapid labor

Acute Respiratory Distress Syndrome (ARDS)

  • Acute pancreatitis
  • Aspiration
  • Bacterial and fungal pneumonias
  • 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 pneumonias

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—

Neonatal Respiratory Distress Syndrome

  • Blood test (gas analysis)
  • Pulse oximetry test
  • X-ray
  • Echocardiogram

Acute Respiratory Distress Syndrome

  • Blood test
  1. Arterial blood gas
  2. complete blood count
  • Chest x-ray
  • CT scan
  • Echocardiogram
  • Bronchoscopy

Treatment—-

Neonatal Respiratory Distress Syndrome

  • 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.

Acute Respiratory Distress Syndrome

  • Oxygen Therapy
  1. Ventilator
  2. Tracheotomy
  • Fluids
  • Medicines

Complications—

Neonatal Respiratory Distress Syndrome

  • Atelectasis
  • Blindness
  • Bronchopulmonary dysplasia
  • Hemorrhage
  • Kidney failure
  • Mental retardation/cerebral palsy.
  • Necrotizing enterocolitis
  • Patent ductus arteriosus(PDA)
  • Pneumothorax
  • Sepsis

Acute Respiratory Distress Syndrome

  • Multiple organ system failure
  • Pneumothorax
  • Pulmonary fibrosis
  • ventilator-associated pneumonia

Prevention—

Neonatal Respiratory Distress Syndrome

  • Regular ante-natal check- ups
  • Healthy diet
  • Avoiding tobacco smoke, alcohol, and illegal drugs
  • Controlling any ongoing medical conditions you have
  • Preventing infection

Acute Respiratory Distress Syndrome

Taking appropriate measures to prevent aspiration( eg. elevation of the head of the bed)               ,

 

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