Infant Respiratory Distress Syndrome (IRDS)

Question 1

What is IRDS?

Answer 1

Common cause of respiratory distress in a newborn, presenting within
hours of birth, normally immediately after delivery

Primarily affects pre-term neonates but less frequently can also affect full
term

Question 2

What is the aetiology of IRDS?

Answer 2

Typically in premature infants; due to immaturity of lungs.

Question 3

What causes IRDS?

Answer 3

Premature birth
Maternal diabetes
C section

Question 4

What is surfactant?

Answer 4

The inside of alveoli is lined with a thin film of water

This and the air inside the alveoli cause surface tension

This surface tension can make the alveoli collapse

Surfactant is anti surface tension

It is an oily secretion that reduces surface tension.

Question 5

What is the pathophysiology behind IRDS?

Answer 5

First inspirations after birth are normally difficult but as time goes on breathing gets easier.

Without surfactant the alveoli collapse during each expiration.

This causes inadequate blood and oxygen supply causing further reduction of surfactant.

This causes partial or complete collapse of a lung and severe hypoxia.

Question 6

What are the signs and symptoms of IRDS?

Answer 6

Tachypnoea

Suprasternal, intercostal and subcostal retraction

Cyanosis

Nasal flaring

Expiratory grunting

Question 7

What is the treatment of IRDS?

Answer 7

Glucocorticoids
Synthetic surfactant given via ET tube or nebula.
Oxygen therapy
CPAP