Respiratory Distress Syndrome

Also known as: RDS, neonatal respiratory distress syndrome, infant respiratory distress syndrome, hyaline membrane disease.

What is respiratory distress syndrome?

Respiratory distress syndrome is one of the most common clinical conditions involving the lungs seen in premature babies. It involves breathing difficulties in the babies, as well as other potential complications.

What causes respiratory distress syndrome?

When a baby’s lungs are fully developed, their air sacs (alveoli) have an adequate amount of a substance called surfactant, which is a liquid produced by the lungs that helps the alveoli to stay open so that a baby can take their first breath and keep the alveoli open when they breathes out.

Premature babies depending on their degree of prematurity, often don’t have enough of this surfactant (it is usually produced by 26 weeks of gestation) and the air sacs collapse after each breath.

This makes the baby have to work harder to open them with each breath in and causes the lungs not to work properly. This is more likely to occur when the baby is less than 28 weeks in gestation.

It is more commonly seen if the baby is a boy, white, has been delivered by cesarean section, or is one of twins (or multiple birth), has had a sibling born with the same condition, if the mother is diabetic, or due to a few other risk factors.

What are the symptoms of RDS?

Severity of symptoms depend on the size and gestational age of the baby. A baby might have RDS if soon after birth they display:

  • rapid or shallow breathing
  • unusual breathing motions or grunting
  • periods when they stop breathing
  • bluish skin color due to lack of oxygen
  • nasal flaring
  • other symptoms

Symptoms may worsen over 48 to 72 hours before potentially improving.

What are respiratory distress syndrome care options?

Babies with respiratory distress syndrome may need immediate treatment with an artificial surfactant replacement (delivered through a breathing tube placed into the baby's airways) and oxygen delivered by a number of mechanisms to assist breathing, these may include:

  • continuous positive airway pressure (CPAP)
  • mechanical ventilation to help with the work of breathing
  • other medications to prevent pain
  • and medications to enable the baby to sleep through the treatment (sedation).

Reviewed by: Jack Wolfsdorf, MD, FAAP

This page was last updated on: July 25, 2022 01:44 PM

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