Respiratory distress syndrome

Question 1

How does pulmonary surfactant deficiency contribute to respiratory distress syndrome?

Answer 1

• High surface tension leading to instability of end expiration, low lung volume and decreased compliance causing atelectasis and hypoxaemia
• Lung inflammation and respiratory epithelial injury leading to pulmonary oedema and increased airway resistance.
• Impaired lung fluid absorption and inefficient clearing of liquid

Question 2

What inactivates surfactant?

Answer 2

Meconium and blood aspiration

Question 3

What is the % incidence of RDS in extremely preterm infants (<28 weeks)?

Answer 3

93%

Question 4

List the principles of preterm RDS treatment

Answer 4

• Prevention through antenatal corticosteroids.
• Assisted ventilation (CPAP or intubation).
• Surfactant therapy
• Caffeine
• Supportive care: normothermia, prevention of fluid overload, maintaining stable cardiovascular state.