Respiratory distress syndrome
Background
- AKA hyaline membrane disease, infantile respiratory distress syndrome, respiratory distress syndrome of the newborn, or RDS
- Due to surfactant deficiency in infants delivered prematurely
- 60% chance of developing RDS if delivered <29wks gestation, 10% of preemies overall, rare in full term infants[1]
- Onset rapid upon delivery
Clinical Features
- Grunting, retractions, hypoxia, cyanosis, or other signs of respiratory distress in a recently delivered premature infant
Differential Diagnosis
- Meconium aspiration syndrome
- Transient tachypnea of the newborn
- Pneumonia
- Sepsis
- Congenital heart disease
- Persistent pulmonary hypertension of the newborn
- Pneumothorax
- Anatomical malformation (e.g. congenital diaphragmatic hernia)
- Anemia, polycythemia
- Upper airway obstruction
Evaluation
- Evaluate for other causes of respiratory distress (e.g. pneumonia, congenital heart disease, etc.)
- CXR: homogenous opaque infiltrates, air bronchograms, decreased lung volumes[2]
Management
- See newborn resuscitation for general management of distressed newborn
- Surfactant replacement (e.g. Servanta) given endotracheally
- Prevented by prenatal corticosteroids between 24-34wks gestation in cases where high risk of preterm delivery[3]
Disposition
- Admit
See Also
External Links
References
- ↑ https://www.thoracic.org/patients/patient-resources/breathing-in-america/resources/chapter-19-respiratory-distress-syndr.pdf
- ↑ Kurl S, Heinonen KM, Kiekara O. The first chest radiograph in neonates exhibiting respiratory distress at birth. Clin Pediatr (Phila). 1997:285–9
- ↑ https://www.aafp.org/afp/2007/1001/p987.html