Respiratory Distress Syndrome

Question 1

Risk factors for respiratory distress syndrome

Answer 1

Prematurity (inadequate surfactant)

Male

Diabetic mothers

Caesarean section

Second born of premature twins

Question 2

Clinical features of respiratory distress syndrome

Answer 2

Tachypnoea

Intercostal recession

Expiratory grunting

Cyanosis

Question 3

Pathophysiology of respiratory distress syndrome

Answer 3

Inadequate surfactant -> high surface tension within alveoli

Leads to atelectasis as alveoli unable to expand

Leads to inadequate gas exchange causing hypoxia, hypercapnia and respiratory distress

Question 4

When does surfactant start being produced?

Answer 4

26 weeks gestation

Adequate levels not achieved until ~36 weeks

Question 5

Investigations in respiratory distress syndrome

Answer 5

CXR shows ground glass appearance

Question 6

Maternal management of respiratory distress syndrome

Answer 6

Antenatal steroids given to mothers with suspected or confirmed preterm gestation

Increases production of surfactant and reduced incidence and severity of respiratory distress syndrome

Question 7

Neonatal management of respiratory distress syndrome

Answer 7

Intubation and ventilation if severe

Endotracheal surfactant

CPAP via nasal mask to keep lungs inflated while breathing

Supplementary O2

Question 8

Short term complications of respiratory distress syndrome

Answer 8

Pneumothorax

Infection

Apnoea

Intraventricular haemorrhage

Pulmonary haemorrhage

Necrotising enterocolitis

Question 9

Long term complications of respiratory distress syndrome

Answer 9

Chronic lung disease of prematurity

Retinopathy of prematurity

Neurological, visual and hearing impairment