Respiratory Distress Syndrome

• thought to be due to deficiency in surfactant production

• occurs within 4 hours of birth

• also known as hyaline membrane disease

Typical Patient

• newborn

• usually pre-term

• surfactant deficiency at term

  • hypoxia

  • acidosis

  • hypothermia

  • born to diabetic mother

Symptoms / Signs

• respiratory distress

  • tachypnoea

  • recession

  • grunting

  • central cyanosis

  • apnoea

Variants

Pathology

• surfactant deficiency

• tendency for alveoli to collapse

• atelectasis

Investigations

• Chest X-ray

  • ground glass appearance

Treatments

• reduced if steroids given 24 hours before birth of preterm (i.e. try to delay labour long enough for steroids to have an effect)

• surfactant

• supplementary oxygen

• ventilatory support

• antibiotics if infection can't be excluded

Prognosis

• clears over 3-7 days

Complications

• infection

• hypoxic damage

• retinopathy of prematurity due to excessive oxygen therapy

• high carbon dioxide increases risk of brain haemorrhage

• low carbon dioxide increases risk of ischaemic brain damage

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