Respiratory Distress Syndrome Flashcards
1
Q
what is RDS also known as?
who does it most commonly occur in?
what is it caused by?
A
- hyaline membrane disease
- premature (70% of 28 weeks)
- infants with diabetic mothers (due to hyperinsulinaemia)
- surfactant deficiency
2
Q
what is surfactant produced by?
A
- Type 2 cells
- reduces surface tension in alveoli
3
Q
what physiological process helps overcome this?
A
- stress of premature birth and developing RDS causes corticosteroid release from the adrenals, stimulating surfactant production
4
Q
what clinical features are there of the increased WOB?
A
- expiratory grunting
- cyanosis
- intercostal, subcostal, sternal recession
- tachypnoea
5
Q
what investigations may you do?
A
- CXR:
- air bronchogram, radiolucent air in bronchi seen against airless lung
- ground glass appearance of lung fields due to alveoli collapse
- bell-shaped thorax
6
Q
how can you manage respiratory distress?
A
- titration of inspired 02 against sats
- CPAP
- mechanical ventilation (IPPV), need intubation
- exogenous surfactant via ET tube, reduces mortality by 40%
7
Q
what complications are there of RDS?
A
- pneumothorax
- pneumonia
- intracranial haemorrhage
- hydrocephalus
- PDA
- NEC
- chronic lung disease
8
Q
what is the prognosis?
A
- 40% develop chronic lung disease
- additional 02 after 28 days
- This is usually self limiting as 02 requirements fall with age
