Holistic care for newborn babies

Neonatal Intensive Care Unit

Respiratory distress syndrome

Preterm babies are at a risk of developing acute respiratory distress syndrome (RDS) within 6 hours of life.

The prime cause of RDS is underlying surfactant deficiency. In the case of preterm babies, as the lungs are underdeveloped, they do not have sufficient surfactants. Due to the lack of surfactant, the lung tends to collapse. This leads to difficulty in breathing as the baby needs to try harder to inflate the lungs. As the lung function is affected, less oxygen is available to the tissues. The rise in levels of carbon dioxide leads to a condition called acidosis. This has adverse effects on the organs of the body.

Symptoms of respiratory distress syndrome:

Babies with respiratory distress syndrome have the following symptoms:

  • Increased respiratory rate (tachypnea)
  • Increased work of breathing (chest indrawing/ retractions)
  • Bluish discolouration (cyanosis)
  • Audible grunt while breathing
  • Flaring nostrils

The symptoms may manifest immediately after birth and they worsen over the period if adequate support is not provided in time.

Diagnosis of respiratory distress syndrome:

A number of methods/tests are used to diagnose respiratory distress syndrome:

  • A physical examination to assess the severity of respiratory distress, bluish discolouration of parts of the body, etc
  • Pulse Oximeter: It is a non-invasive device that measures the oxygen saturation levels in the blood.
  • Arterial Blood Gas Test (ABG): This is a specific blood test which measures the amount of oxygen and carbon dioxide in the blood. The severity of RDS can also be determined with this test
  • X-ray: A chest x-ray plays a major role in diagnosing the presence of RDS and as well as determines the severity of RDS.

Treatment of respiratory distress syndrome:

All high-risk pregnancies (pregnancy in women with advanced age, or pre-existing condition of diabetes or hypertension), has an increased chance of delivering a preterm baby. In such cases where the situation is foreseen, the health care provider suggests an antenatal steroids to the mother before the delivery. Which are known to enhance the maturity of fetal lung maturity.

The preterm babies who show the symptoms of RDS are shifted to the Neonatal Intensive Care unit.

If the severity of RDS is mild, nasal prongs are provided. However, if the severity is high, a CPAP or ventilator may be used to support the breathing process.

Intratracheal administration of surfactant is also performed on the babies who have severe RDS with higher oxygen requirements.

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