Respiratory distress syndrome (RDS), which used to be called hyaline membrane disease, is one of the most common problems of premature babies. It can cause babies to need extra oxygen and help breathing. The course of illness with respiratory distress syndrome depends on the size and gestational age of the baby, the severity of the disease, the presence of infection, whether or not a baby has a patent ductus arteriosus (a heart condition), and whether or not the baby needs mechanical help to breathe. RDS typically worsens over the first 48 to 72 hours, then improves with treatment. Show What causes RDS?RDS occurs when there is not enough of a substance in the lungs called surfactant. Surfactant is a liquid produced by the lungs that keeps the airways (called alveoli) open, making it possible for babies to breathe in air after delivery. It begins to be produced in the fetus at about 26 weeks of pregnancy. When there is not enough surfactant, the tiny alveoli collapse with each breath. As the alveoli collapse, damaged cells collect in the airways and further affect breathing ability. The baby works harder and harder at breathing, trying to reinflate the collapsed airways. As the baby's lung function decreases, less oxygen is taken in and more carbon dioxide builds up in the blood. This can lead to increased acid in the blood called acidosis, a condition that can affect other body organs. Without treatment, the baby becomes exhausted trying to breathe and eventually gives up. A mechanical ventilator (breathing machine) must do the work of breathing instead. Who is affected by RDS?RDS occurs most often in babies born before 28 weeks gestation. Some premature babies develop RDS severe enough to need a mechanical ventilator (breathing machine). The more premature the baby, the higher the risk and the more severe the RDS.
What are the symptoms of RDS?The following are the most common symptoms of RDS. However, each baby may experience symptoms differently. Symptoms may include:
The symptoms of RDS usually peak by the third day, and may resolve quickly when the baby begins to diurese (excrete excess water in urine). When a baby improves, he or she begins to need less oxygen and mechanical help to breathe. The symptoms of RDS may resemble other conditions or medical problems. Always consult your baby's doctor for a diagnosis. How is RDS diagnosed?RDS is usually diagnosed by a combination of assessments, including the following:
Treatment for RDSSpecific treatment for RDS will be determined by your baby's doctor based on:
Treatment for RDS may include:
Complications of RDSBabies with RDS sometimes develop complications of the disease or problems as side effects of treatment. As with any disease, more severe cases often have greater risks for complications. Some complications associated with RDS include the following:
Prevention of RDSPreventing a preterm birth is the primary means of preventing RDS. When a preterm birth cannot be prevented, giving the mother medications called corticosteroids before delivery has been shown to dramatically lower the risk and severity of RDS in the baby. These steroids are often given to women between 24 and 34 weeks gestation who are at risk of early delivery. However, if the delivery is very quick or unexpected, there may not be time to give the steroids, or they may not have a chance to begin working. Why preterm infants are at higher risk of infection?Although all newborns are at an increased risk of developing infections, this is particularly true of premature babies because their immune systems haven't fully matured. As a result, they may not be able to adequately fight off bacteria, fungi, viruses and other organisms that can cause infections.
How does premature birth affect the lungs?Those born prematurely (very to moderate preterm) also had reduced lung function measures, suggesting that prematurity may affect the development of both small and large airways. This study is the first to show that being born prematurely is a risk factor for COPD that can become apparent in later mid-adult life.
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