Respiratory Distress Syndrome (Newborn)

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Respiratory Distress Syndrome(Newborn)

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Respiratory Distress Syndrome

Respiratory distress syndrome (hyalinemembrane disease) is a breathing disorder

of premature newborns in which the air sacs(alveoli) in a newborn's lungs do not remainopen because the production of a substancethat coats the alveoli (surfactant) is absentor insufficient.

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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 thelungs inflate with air and keeps the air sacs fromcollapsing. This substance normally appears in maturelungs.

It can also be the result of genetic problems with lungdevelopment.

The earlier a baby is born, the less developed the lungsare and the higher the chance of neonatal RDS. Mostcases are seen in babies born before 28 weeks. It isvery uncommon in infants born full-term (at 40 weeks).

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following increase the risk of neonatal RDS:

A brother or sister who had RDSDiabetes in the motherCesarean deliveryDelivery complications that lead to acidosis in the

newborn at birthMultiple pregnancy (twins or more)Rapid laborThe risk of neontal RDS may be decreased if the

pregnant mother has chronic, pregnancy-relatedhigh blood pressure or prolonged rupture of membranes, because the stress of thesesituations cause the infant's lungs to maturesooner.

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SymptomsThe 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 outputGruntingNasal flaringPuffy or swollen arms or legsRapid breathing

Shallow breathingShortness of breath and grunting sounds while breathingUnusual breathing movement -- drawing back of the chest

muscles with breathing

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Exams and Tests

A blood gas analysis shows low oxygen and excessacid in the body fluids.

A chest x-ray shows respiratory distress. The lungshave 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 sepsisas a cause of the respiratory distress.

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TreatmentHigh-risk and premature infants require prompt

attention by a neonatal resuscitation team.Despite greatly improved RDS treatment in recent

years, many controversies still exist. Deliveringartificial surfactant directly to the infant's lungscan be enormously important, but how muchshould be given and who should receive it andwhen is still under investigation.

Infants will be given warm, moist oxygen. This iscritically important, but needs to be givencarefully to reduce the side effects associatedwith too much oxygen.

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A breathing machine can be lifesaving, especiallyfor babies with the following:

High levels of carbon dioxide in the arteriesLow blood oxygen in the arteries

Low blood pH (acidity)

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A treatment called continuous positive airway pressure(CPAP) that delivers slightly pressurized air through the

nose can help keep the airways open and may preventthe need for a breathing machine for many babies.Even with CPAP, oxygen and pressure will be reduced assoon as possible to prevent side effects associated withexcessive oxygen or pressure.

A variety of other treatments may be used, including:

Extracorporeal membrane oxygenation (ECMO) to directlyput oxygen in the blood if a breathing machine can't beused

Inhaled nitric oxide to improve oxygen levels

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It is important that all babies with RDS receiveexcellent supportive care, including thefollowing, which help reduce the infant'soxygen needs:

Few disturbancesGentle handlingMaintaining ideal body temperatureInfants with RDS also need careful fluid

management and close attention to othersituations, such as infections, if theydevelop.

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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 for5. 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 infant8.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.