2. INTRODUCTION
Respiratory distress syndrome (RDS) occurs in
babies born early (premature) whose lungs are
not fully developed. The earlier the infant is born,
the more likely it is for them to have RDS and
need extra oxygen and help breathing.
RDS is caused by the baby not having enough
surfactant in the lungs. Surfactant is a liquid
made in the lungs at about 26 weeks of
pregnancy. As the fetus grows, the lungs make
more surfactant.
3. Surfactant coats the tiny air sacs in the
lungs and to help keep them from
collapsing (Picture 1). The air sacs
must be open to allow oxygen to enter
the blood from the lungs and carbon
dioxide to be released from the blood
into the lungs. While RDS is most
common in babies born early, other
newborns can get it.
4. SIGNS AND SYMPTOMS
• Fast breathing very soon after birth
• Grunting “ugh” sound with each breath
• Changes in color of lips, fingers and toes
• Widening (flaring) of the nostrils with each breath
• Chest retractions - skin over the breastbone and ribs pulls in
during breathing
5. HOW WILL A DOCTOR FIND OUT
WHETHER A NEWBORN HAS RDS?
RDS is common in premature newborns, but doctors may need to
run tests to rule out other types of newborn breathing conditions.
After doing a physical examination to look at a newborn’s
symptoms, your provider may order one or more of the tests below.
• Lung imaging tests such as chest X-rays show how well the
how well the lungs and heart are working. X-rays are used to
diagnose most types of newborn breathing conditions.
• Heart tests such as an echocardiogram can check for a
for a possible congenital heart defect.
• Blood tests look for an infection.
6.
7. WHAT CAUSES RDS?
• Surfactant is a foamy substance that keeps the lungs fully expanded so
that newborns can breathe in air once they are born. Without it, the
lungs collapse, and the newborn must work hard to breathe. This can
cause the baby’s organs to be without necessary levels of oxygen
• If a full-term baby develops RDS, it may be because they have
faulty genes that affect how their bodies make surfactant.
8. HOW IS RDS TREATED?
The earlier a baby is born, the more likely they are to have RDS that cannot
be prevented. Nearly all babies born before 28 weeks of pregnancy will have
RDS. With treatment, many newborns that are diagnosed with RDS will recover.
Some common treatments include those listed below.
• Nasal continuous positive airway pressure (nCPAP): This device provides
device provides breathing support by gently pushing air into the baby's lungs
through prongs placed in the nose.
• Surfactant replacement therapy: This can be used if a newborn struggles to
newborn struggles to breathe despite the use of nCPAP. Sometimes, giving an
infant surfactant requires the use of a breathing tube. If so, because of the
possible complications, your baby’s provider will help you consider the risks
and benefits of the procedure.
9. • Mechanical ventilation: This is used only in very
serious cases of RDS. A ventilator is a machine that
of breathing and is a form of life support. The
breathing tube that runs through a newborn’s mouth
the windpipe. Babies that require ventilation are more
develop bronchopulmonary dysplasia. They may also
problems from the breathing tube or ventilator, such
lung injury.
• Fluids and nutrients: These may be given to help
prevent malnutrition and promote growth. Nutrition
growth and development of the lungs.
10. OUTLOOK (PROGNOSIS)
The condition often gets worse for 2 to 4 days after
birth and improves slowly after that. Some infants with
severe respiratory distress syndrome will die. This most
often occurs between days 2 and 7.
Long-term complications may develop due to:
• Too much oxygen.
• High pressure delivered to the lungs.
• More severe disease or immaturity. RDS can be
associated with inflammation that causes lung or
brain damage.
• Periods when the brain or other organs did not get
enough oxygen.
