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)               ,