Respiratory Distress Syndrome Flashcards
What is the pathophysiology of respiratory distress syndrome?
Deficiency of alveolar surfactant, commonest in premature babies. Insufficient surfactant causes atelectasis. Re-inflation with each breath exhausts baby and respiratory failure follows.
What are the risk factors for respiratory distress syndrome?
Prematurity, male, maternal diabetes mellitus
What is this a presentation of?
Within 4 hours of birth, tachypnoea, expiratory grunting, nasal flaring, intercostal recession, cyanosis (<92% on air).
Respiratory distress syndrome
How should you investigate respiratory distress syndrome?
- Chest x-ray - ground glass appearance
2. Air bronchogram
What are the important differentials of respiratory distress syndrome?
Sepsis, transient tachypnoea of the newborn, meconium aspiration, congenital lung abnormality, congenital diaphragmatic hernia.
How do you differentiate respiratory distress syndrome from transient tachypnoea of the newborn?
Chest x-ray:
- RDS - ground glass appearance
- TTN - hyperinflated lungs, fluid in horizontal fissure
How is transient tachypnoea of the newborn treated?
Oxygen to maintain saturations, usually resolves after 24 hours.
What is the management for respiratory distress syndrome?
- Betamethasone/dexamethasone to all mothers 24-34+6/40 at risk of preterm delivery.
- Give oxygen, stabilise with CPAP, aim sats 85-93%
- If RDS severe - intubate and give exogenous surfactant through ET tube.
What are the complications of respiratory distress syndrome?
- Bronchopulmonary dysplasia
2. Pneumothorax
What causes bronchopulmonary dysplasia?
- Occurs in babies with very low birth weight (<1kg)
2. Chronic lung inflammation, prolonged mechanical ventilation, oxygen toxicity, infection.
How is bronchopulmonary dysplasia investigated and treated?
- Clinical diagnosis, USS - fibrotic and cystic areas
2. Prevention, gentle ventilation, high calorific feeds for lung repair.
