Millions of babies are born early every year across the world with undeveloped lungs. RDS results when such children are delivered prematurely and their lungs have not grown adequately. Neonatal Medicine Has a Major Concern RDS and There Is Need to Understand Its Causes, Symptoms, Treatment Options and Preventions to Salvage Premature Infants.
What is Respiratory Distress Syndrome (RDS)?
Hyaline Membrane Disease or Respiratory Distress Syndrome mainly targets early-born preterm infants; often these are babies who have been born before 28 weeks of gestation. It happens due to insufficient amounts of surfactants- the substance that permits air sacs within the lungs to remain open and help them expand and collapse with ease in the case of premature babies. The small air sacs of the lungs collapse if there is not enough surfactant resulting in a baby having trouble breathing.
Causes of RDS
The main reason why premature babies suffer from RDS is due to a lack of surfactant. The surfactant is usually produced by type II pneumocytes which are specialized cells in the lungs of a newborn baby. Production of Surfactant by these cells commences only during the third trimester of pregnancy. Hence, premature babies have undeveloped lungs which fail to produce adequate surfactants for normal breathing.
Additional risk factors that can increase the likelihood of RDS include:
Premature Birth: Babies with shorter periods of gestation prior to birth have a greater chance of contracting RDS.
Maternal Diabetes: RDS is more common in infants whose mothers have poorly controlled diabetes.
Multiple Pregnancies: Multiples such as twins, triplets and others have a higher likelihood of being born pre-term hence heightening chances of RDS.
Maternal Infections: Preterm birth is also likely due to infections in the mother which can increase the risk of RDS among others.
Symptoms of RDS
Recognizing the signs of RDS in preterm infants is crucial for early diagnosis and treatment. Common symptoms of RDS include:
Rapid, Shallow Breathing: Preterm infants with RDS often breathe very quickly, and their breaths may appear shallow and labored.
Grunting: Some babies with RDS make grunting sounds when they exhale, which is a sign of the effort required to breathe.
Nasal Flaring: Infants with RDS may flare their nostrils when breathing to try and get more air.
Cyanosis (Blue Tint): Due to the inadequate oxygen exchange in the lungs, babies with RDS may develop a bluish tint to their skin and lips.
Retractions: The chest and the area just below the ribcage may appear to 'pull in' during breathing, indicating that the baby is working hard to breathe.
Apnea (Breathing Pauses): Infants with RDS may experience brief pauses in their breathing.
Decreased Lung Sounds: Doctors may hear less air movement in the baby's lungs when listening with a stethoscope.
Diagnosis and Trеatmеnt
Prompt diagnosis and intеrvеntion arе еssеntial whеn RDS is suspеctеd. Diagnosis typically involves a combination of clinical signs, chеst X-rays, and blood gas mеasurеmеnts. Oncе diagnosеd, trеatmеnt may involvе thе following intеrvеntions:
Surfactant Rеplacеmеnt Thеrapy: This is a kеy trеatmеnt for RDS. Exogеnous surfactant, which is a synthеtic or animal-dеrivеd surfactant, is administеrеd through a tubе placеd in thе baby's airway. This helps to stabilizе and opеn thе air sacs in thе lungs.
Mеchanical Vеntilation: For morе sеvеrе casеs of RDS, mеchanical vеntilation with a vеntilator is nеcеssary. This machinе hеlps thе baby brеathе by dеlivеring oxygеn and maintaining propеr lung prеssurе.
Oxygеn Thеrapy: Babiеs with RDS may rеquirе supplеmеntal oxygеn to maintain appropriate oxygеn lеvеls in their blood.
Continuous Positivе Airway Prеssurе (CPAP): CPAP is a lеss invasivе form of rеspiratory support that hеlps kееp thе airways opеn and improvе oxygеnation.
Supportivе Carе: Prеtеrm infants with RDS may rеquirе supportivе carе in a nеonatal intеnsivе carе unit (NICU). This includеs maintaining body tеmpеraturе, providing adеquatе nutrition, and monitoring for any complications.
Antеnatal Stеroids: In somе casеs, whеn prеtеrm birth is anticipatеd, antеnatal stеroids may bе administеrеd to thе mothеr. Thеsе stеroids hеlp accеlеratе thе dеvеlopmеnt of thе baby's lungs and rеducе thе risk of RDS.
Prevention
Preventing RDS in preterm infants is a complex challenge, but certain strategies can help reduce the risk:
Antenatal Care: It also enables the identification and control of pregnancy-related complications like infection/diabetes that may contribute to an early delivery.
Antenatal Steroids: Antenatal Use of Steroids to Prevent Preterm Delivery
Delayed Cord Clamping: The baby's benefit is increased by letting some period pass with them still being attached to the umbilical cord.
Specialized Neonatal Care: The babies who are preterm and at a higher risk of RDS, must be delivered in hospitals that have a dedicated nursery so that care is provided instantly.
Surfactant Replacement: In some hospitals, prophylactic surfactant replacement is administered to very preterm infants who have not yet developed signs of RDS.
Conclusion
Preterm Infant respiratory distress syndrome – A continuing challenge for preterm infants and families. RDS affects babies born prematurely or during caesarian deliveries; however, timely diagnosis, surfactant replacement therapy medication, and changes in newborn care have seen a dramatic improvement in this disease condition. A good neonatologist is at the heart of this progress, tirelessly working to safeguard the health and well-being of preterm infants facing the challenges of RDS.