Respiratory Distress Syndrome

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.


  • 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.



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


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



  • 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.


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


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


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),

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