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Respiratory Distress Syndrome (RDS)

With this, there's a lack of surfactant, which increases the surface tension within alveoli, causing them to collapse. This in turn leads to hypoxia, hypercapnia, and respiratory distress. It affects premature babies as surfactant levels only reach an adequate level from 35 weeks gestation.


It presents with Cyanosis, Rapid shallow breathing, Nasal flaring, and a Grunting sound when breathing.


Investigations

  • Bloods – Check O2 and for infection

  • Chest XR – Ground-glass appearance

“Chest radiograph one day after birth of a boy after 29 weeks and 3 days of gestational age who developed respiratory distress. It shows signs of infant respiratory distress syndrome (IRDS), in the form of a generalized fine granular opacities that creates air bronchograms. The thorax is bell-shaped due to decreased lung volume. In addition, there are both arterial and venous umbilical lines, a nasogastric tube and electrocardiography electrodes.” © Mikael Häggström, M.D. CC0 1.0 (https://commons.wikimedia.org/wiki/File:X-ray_of_infant_respiratory_distress_syndrome_(IRDS).png)

Management

Before birth - Corticosteroids (i.e. Dexamethasone) – to increase surfactant production before birth, and subsequently reduce the severity of respiratory distress


After birth - Endotracheal surfactant


Complications

  • Short-term - Pneumothorax, Infection, Apnoea, Intraventricular/Pulmonary haemorrhage

  • Long-term - Chronic lung disease of prematurity, Retinopathy of prematurity, Neurological, hearing and visual impairment



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