Respiratory Distress Syndrome

in infant
Illustrations
Definition
Causes,incidence,and risk factors
Symptoms
Complications
Signs and tests
Treatment
Prognosis
 Illustrations

The major features of the lungs include the

bronchi, the bronchioles and the alveoli. The
alveoli are the microscopic blood vessel-lined
sacks in which oxygen and carbon dioxide gas
are exchanged.
 Definition

Respiratory distress syndrome is one of the

most common lung disorders in premature
infants. The condition makes it hard to
breathe

Neonatal respiratory distress syndrome

(NRDS) is caused by a deficiency in
pulmonary surfactant (PS) and is one of
the main reasons of neonatal mortality.
from 34 to 37 weeks gestation, the cells in
the alveoli normally produce a substance
called surfactant

surfactant
is kind of phosphatide and produced by
the type Ⅱalveolar cells .
reduces the surface tension of fluids that
coat the lungs so the air sacs can expand at
birth and the infant can breathe normally.
 Causes,incidence,and risk
factors
Causes
When an infant is born prematurely(<32 weeks),
their lungs have not produced the necessary
amount of surfactant.Without surfactant, the lungs
can not inflate, resulting in RDS.
The lack of this chemical causes the
alveolar to collapse and prevents the child from
breathing properly. Symptoms usually appear
shortly after birth and slowly become more severe.
Incidence
• The incidence of RDS declines with degree of
maturity at birth.
• It occurs in 60 % of babies born at less than 28
weeks' gestation, 30% of those born at 28 to 34
weeks, and less than 5% of those born after 34
weeks.
• In 2003, the RDS mortality rate (per 100,000 live
births) among African Americans was 43.7, versus
16.8 among whites--a difference of more than 62
percent.
Risk factors

 Prematurity
 Diabetes in the mother
 acidosis
 Symptoms
 Onset

Usually less than 2-5 hours after birth

Increases in severity from 24 to 48 hours
Then, gradual improvement after 48-72 hours
 Abnormal retraction of chest wall
 Cyanosis
 Expiratory grunting
 Increased respiratory rate
 Complications
 Sepsis
 Hemorrhage :Pulmonary hemorrhage ,Intracranial
hemorrhage
 pneumothorax(collapse of lung)
 bronchopulmonary dysplasia: may develop
as a result of oxygen toxicity, high pressures delivered to
the lungs during mechanical ventilation or the severity of
the condition itself.
 Signs and tests
A blood gas analysis shows low oxygen and
acidosis.
 A chest x-ray indicates respiratory distress (the
lungs develop a characteristic "ground glass"
appearance).
 Lung function studies may be necessary.
 Blood cultures and a sepsis work-up are usually
done to rule out infection and sepsis as a cause of
the respiratory distress.
 Treatment

 Glucocorticoids: on 48h before birth, 5mg,tid,im×2 days

 Supportive therapy
 High oxygen and humidity concentrations
 Assisted ventilation
 Exogenous surfactant via trachea :
60-100mg/kg
 Prognosis

 Thecondition may persist or worsen for 2 to 4

days after birth with improvement thereafter.
Some infants with severe respiratory distress
syndrome will die.

 Long-term complications may develop as a

result of oxygen toxicity, high pressures
delivered to the lungs, the severity of the
condition itself, or periods when the brain or
other organs did not receive enough oxygen.