Neonatology - RDS

Question 1

Who is affected by RDS?

Answer 1

Premature neonates

Before Type II pneumocytes can start producing adequate surfactant

Question 2

What does a CXR with RDS show?

Answer 2

Ground-glass appearance

Question 3

What is the pathophysiology of RDS?

Answer 3

Inadequate surfactant leads to high surface tension within alveoli

This causes atelectasis as it is more difficult for the alveoli and lungs to expand

Inadequate gas exchange causing hypoxia, hypercapnia and respiratory distress

Question 4

How is RDS managed antenatally?

Answer 4

Antenatal steroids dexamethasone

Increases surfactant production
Reduces chance of RDS
Reduces severity of RDS

Question 5

How is RDS managed in premature neonates?

Answer 5

• Intubation and ventilation
• Endotracheal surfactant
• CPAP
• Supplementary oxygen

Question 6

What oxygen saturations are normal in preterm neonates?

Answer 6

91-95%

Question 7

What are the short term complications of RDS?

Answer 7

• PTX
• Infection
• Apnoea
• Intraventricular haemorrhage
• Pulmonary haemorrhage
• Necrotising enterocolitis

Question 8

What are the long term complications of RDS?

Answer 8

Chronic lung disease of prematurity
ROPS
Neurological, hearing and visual impairment