RDS Flashcards
What is Respiratory Distress Syndrome (RDS) in neonates?
A condition caused by pulmonary surfactant deficiency in the lungs of neonates, most commonly those born before 37 weeks gestation.
What does pulmonary surfactant do in the lungs?
It diminishes the surface tension of the water film lining the alveoli, decreasing the tendency for alveoli to collapse and reducing the work required to inflate them.
What population is most commonly affected by Respiratory Distress Syndrome?
Preterm neonates, Small for Gestational Age (SGA), and Large for Gestational Age (LGA) infants.
What is the pathophysiology of RDS in neonates?
Poor oxygen exchange leads to tissue hypoxia, causing the release of lactic acid and increasing CO2, resulting in severe acidosis.
What effect does acidosis have on neonates with RDS?
It causes vasoconstriction, decreases pulmonary perfusion, and limits surfactant production.
What are the early symptoms and signs of Respiratory Distress Syndrome?
Grunting respirations, use of accessory muscles, nasal flaring, and retractions soon after birth.
What symptoms develop as Respiratory Distress Syndrome progresses?
Cyanosis, lethargy, irregular breathing, apnea, and respiratory failure.
What findings are noted on examination of a neonate with RDS?
Decreased breath sounds, decreased peripheral pulses, peripheral extremity edema, and decreased urine output.
How is Respiratory Distress Syndrome diagnosed?
Diagnosis is clinical and based on clinical presentation, ABG results showing hypoxemia and hypercapnia, chest x-ray with a ground glass appearance, and cultures from blood, CSF, and tracheal aspirate.
What does a chest x-ray typically show in a neonate with RDS?
A ground glass appearance.
What is the primary treatment for Respiratory Distress Syndrome?
Surfactant therapy, oxygen administration, and ventilation.
What supportive care is important in managing RDS in neonates?
Keeping the infant warm to reduce acidosis and metabolic oxygen demand, and providing hydration and nutrition via IV fluids, glucose, or gavage feeding.
Why is keeping a neonate warm important in RDS management?
Cooling increases acidosis in all newborns, so warmth reduces metabolic oxygen demand.
Why is IV fluids or gavage feeding necessary in neonates with RDS?
Because the respiratory effort makes an infant too exhausted to suck.
What are some additional treatments used in severe cases of RDS?
Muscle relaxants like Pancuronium (Pavulon), extracorporeal membrane oxygenation (ECMO), liquid ventilation with perfluorocarbons, and inhaled Nitric Oxide for pulmonary vasodilation.
What does Pancuronium (Pavulon) do in the management of RDS?
It abolishes spontaneous respiratory action by relaxing muscles.
What is ECMO and how does it help neonates with RDS?
Extracorporeal Membrane Oxygenation (ECMO) provides adequate oxygenation when conventional ventilation fails.
What is liquid ventilation in the treatment of RDS?
It involves the use of perfluorocarbons to improve oxygenation and ventilation in neonates with RDS.
How does inhaled Nitric Oxide help neonates with RDS?
It causes pulmonary vasodilation, improving blood flow and oxygenation.
How can prenatal risk for RDS be assessed?
With tests of fetal lung maturity.
