Respiratory distress syndrome Flashcards
What is respiratory distress syndrome?
Respiratory distress syndrome is assoc. with prematurity, caused by insufficient surfactant production and structural immaturity of the lungs.
What is surfactant and why does lack of it cause respiratory distress syndrome?
Surfactant is a phospholipid-containing fluid produced by type 2 pneumocytes.
Surfactant acts to lower the surface tension in the alveoli, which helps to keep them open.
A lack of surfactant increases surface tension and causes alveoli to collapse, triggering respiratory distress.
When is surfactant made?
Surfactant is made from 26 weeks gestation - adequate levels are not achieved until 35 weeks.
This means that premature babies do not have enough surfactant
What are the risk factors for respiratory distress syndrome?
Male sex
Diabetic mothers
Caesarean section
Second born of premature twins
What are the clinical features of respiratory distress syndrome?
Tachypnoea
Intercostal recession
Expiratory grunting
Cyanosis
How is respiratory distress syndrome diagnosed?
Through clinical evaluation
A ‘ground glass’ appearance and an indistinct heart border on chest x-ray.
How is respiratory distress syndrome managed?
Prevention during pregnancy if preterm delivery is suspected: antenatal maternal corticosteroids to induce foetal lung maturation and surfactant production.
=> Glucocorticoids bind to nuclear steroid receptors to trigger surfactant synthesis.
Treatment in preterm infants is exogenous artificial surfactant given via endotracheal tube
Assisted ventilation + oxygen
What are the complications of respiratory distress syndrome?
Major cause of pre-term infant mortality therefore prompt recognition and treatment is crucial
Pneumothorax
Chronic lung disease
Bronchopulmonary dysplasia
Respiratory distress syndrome assoc. with maternal diabetes and meconium in term babies. Surfactant is produced but is ineffective.
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