Infant Respiratory Distress Syndrome
1 AnswerIntermountain Registered Dietitians, Nutrition & Dietetics, answered on behalf of Intermountain HealthcareRespiratory distress syndrome (RDS) is a breathing disorder in premature babies that is most often caused by their inability to produce surfactant. Surfactant is the fatty substance that coats the tiny sacs in the lungs to keep them from collapsing. Other causes of respiratory distress can be infection or breathing meconium (the baby's first stool) or fluid into the lungs.
The goals of treatment of the infant with respiratory distress syndrome (RDS) are:
- To decrease the amount of energy used by the infant to accomplish the work of breathing and
- To maintain adequate blood gases to prevent organ damage.
These infant are frequently given oxygen either via continuous positive airway pressure (CPAP) or via an endotracheal tube with a mechanical device. In addition an exogenous preparation of surfactant may be given to promote the development of the lining of the lungs.
The diagnosis of respiratory distress syndrome (RDS) begins with gathering information about the infant gestational age at birth and any maternal history or events during the labor and birth process associated with RDS. The initial examination of the infant will assess for the presence of retractions, grunting or nasal flaring. Vital signs, especially respiratory rate and pattern and a pulse oximeter reading are also completed. If there is evidence of RDS a blood gas will be collected and a chest x-ray ordered to confirm the diagnosis and to guide the treatment plan.
There are 3 classic symptoms associated with respiratory distress syndrome:
- Intracostal retractions as the infant uses accessory muscles to support the work of ventilation
- Grunting as the epiglottis attempts to keep air in the lungs
- Nasal flaring as the infant attempts to take in additional air.
Later signs of the infant's deteriorating condition include a change in the respiratory rate and apnea and the presence of cyanosis, especially around the oral area.
2 AnswersStacy Wiegman, PharmD, Pharmacy, answered
Neonatal respiratory distress syndrome (neonatal RDS) is most common in premature babies. Babies born before 28 weeks of pregnancy are most likely to develop neonatal RDS. Other babies may develop neonatal RDS if they are at high risk for the disorder. This includes babies with siblings who had RDS, with a mother who has diabetes, a caesarean delivery, acidosis caused by delivery complications, being part of a multiple pregnancy and a quick labor period. Sometimes doctors may know before birth that a baby will be born with neonatal RDS.