Respiratory distress syndrome (RDS) is a condition that affects premature babies when their lungs can’t provide enough oxygen to their body.
Respiratory distress syndrome (RDS) is a life-threatening condition. It is caused by the baby’s lungs not being fully developed, which makes it difficult for them to breathe. In this blog post, we will discuss the causes, symptoms, and treatment of respiratory distress syndrome.
What is respiratory distress syndrome?
Respiratory distress syndrome (RDS) is a condition that results when the lungs are unable to provide enough oxygen to the body.
It is most common in preterm newborns, babies born to diabetic mothers, and infants delivered by cesarean section or following breech delivery but can occur at any age. RDS can be life-threatening, but with early diagnosis and treatment, most people recover fully.
What causes respiratory distress syndrome?
RDS is caused by a lack of surfactant, a substance that helps keep the air sacs in the lungs open. A surfactant is a liquid produced in the lungs during pregnancy at around 26 weeks. The lungs generate more surfactant as the fetus develops. Surfactant protects the tiny air sacs in the lungs from collapsing. Air sacs must be open to allow oxygen into the circulation via the lungs and carbon dioxide out of the circulation.
RDS can be due to several risk factors, including:
- Premature birth
- Congenital lung abnormalities
- Infection of the lungs or airways
- Injury to the lungs
What are the symptoms of respiratory distress syndrome?
The symptoms of RDS vary depending on the severity of the condition. In mild cases, infants may have rapid breathing and a mild increase in heart rate. In more severe cases, infants may have difficulty breathing, grunting with each breath, and flaring of the nostrils.
They may also have a bluish tinge to their skin (cyanosis) due to a lack of oxygen.
How is respiratory distress syndrome diagnosed?
RDS is typically diagnosed based on the symptoms and medical history. A physical examination may also be performed. In some cases, X-rays or other imaging tests may be ordered to rule out other conditions.
How is respiratory distress syndrome treated?
RDS is treated with supplemental oxygen and, in some cases, mechanical ventilation. If your child has RDS, they will be closely monitored by a team of healthcare providers in the neonatal intensive care unit (NICU).
The goal of treatment is to help your child breathe easier and get the oxygen they need. Babies with RDS require more oxygen. It may be given in several ways:
- Nasal cannula: A thin, soft tube is placed under the nose and delivers oxygen.
- Oxygen hood: A clear plastic hood that covers your baby’s head and provides oxygen.
- Incubator: A clear plastic box that keeps your baby warm and provides oxygen.
- Mechanical ventilation: It is a breathing machine used to help your baby breathe. In most cases, infants with RDS improve within the first week of life and can be discharged from the hospital by the time they are two weeks old. Babies who require mechanical ventilation may have a longer hospital stay.
- Continuous positive airway pressure (CPAP): A machine that helps keep the airways open and delivers oxygen.
- Surfactant replacement therapy: A treatment that replaces the surfactant in the lungs. It is given through a breathing tube placed in the baby’s windpipe (endotracheal tube).
- High-frequency ventilation (HFV): A type of mechanical ventilation that uses high-frequency breaths to help infants with RDS breathe.
- Extracorporeal membrane oxygenation (ECMO): A life-support system that takes over the function of the lungs. ECMO is used in severe cases of RDS that do not respond to other treatments.
Babies with RDS often require supplemental oxygen for several weeks after they are discharged from the hospital. In some cases, they may need to see a pulmonologist (lung specialist) or other specialists for long-term care.
What are the complications of RDS?
The main complication of RDS is respiratory failure, which can be life-threatening. Other complications include:
- Pneumonia: It is an infection of the lungs that can occur when breathing tubes are in place or from exposure to viruses after birth.
- Pneumothorax: It is a condition in which air leaks into the space between the lungs and chest wall. This can cause the lung to collapse and lead to breathing problems.
- Apnea: A period when breathing stops. It can be caused by the immature nervous system or by low levels of oxygen.
- Bronchopulmonary dysplasia (BPD): A chronic lung condition that can occur in babies who have had RDS and required mechanical ventilation.
- Neurodevelopmental delay: Babies with RDS may have a delay in reaching developmental milestones, such as sitting, crawling, and walking.
- Retinopathy of prematurity (ROP): A condition that can occur in premature babies who have received supplemental oxygen. It is a leading cause of blindness in children.
- Patent ductus arteriosus (PDA): A heart condition that can occur in premature babies. It is a common complication of RDS.
- Intraventricular hemorrhage (IVH): A condition in which bleeding occurs in the brain.
- Necrotizing enterocolitis (NEC): A condition in which the lining of the intestine dies. It is a serious complication that can occur in premature babies.
How can I prevent respiratory distress syndrome?
There is no way to prevent RDS. However, it can be treated with prompt medical care. If you are pregnant and have a history of preterm labor or premature birth, you should be monitored closely by your healthcare provider.
You may be given steroids before birth to help speed up the development of your baby’s lungs. If you are pregnant with more than one baby, you may be given magnesium sulfate to help prevent preterm labor.
Tips for parents of a baby with RDS
The most important thing you can do for your baby with RDS is to provide them with the necessary oxygen and respiratory support. If your baby is having difficulty breathing, you may need to provide them with supplemental oxygen. You should also monitor their heart rate and blood pressure closely. If your baby is not responding to oxygen therapy, they may need to be intubated and placed on a ventilator.
What are the long-term effects of respiratory distress syndrome?
RDS generally does not cause any long-term effects. However, infants who experience RDS are at increased risk of developing bronchopulmonary dysplasia (BPD), a chronic lung condition that can require lifelong treatment.
BPD occurs when the lungs are damaged due to mechanical ventilation and other treatments used to manage RDS. Fortunately, with advances in medical care, the number of infants who develop BPD has decreased in recent years.