Respiratory distress syndrome (RDS)

Question 1

Who does RDS affect?

Answer 1

Premature neonates, born before the lungs start producing adequate surfactant

Question 2

What is the pathophysiology of RDS?

Answer 2

Inadequate surfactant leads to high surface tension within alveoli. This leads to atelectasis (lung collapse), as it is more difficult for the alveoli and the lungs to expand. This leads to inadequate gas exchange, resulting in hypoxia, hypercapnia and respiratory distress.

Question 3

How can it be managed, and what drug would be used to achieve this?

Answer 3

Antenatal steroids (i.e. dexamethasone) to increase surfactant production in the baby before birth

Question 4

Name 1 treatment that may be given to a neonatal baby with RDS

Answer 4

• Intubation and ventilation
• Endotracheal surfactant
• Continuous positive airway pressure (CPAP)
• Supplementary oxygen

Question 5

1) Name a potential short term complication
2) Name a potential long term complication

Answer 5

1) Pneumothorax, infection, apnoea, intraventricular haemorrhage, pulmonary haemorrhage, necrotising enterocolitis
2) Chronic lung disease of prematurity, retinopathy of prematurity, neurological, hearing and visual impairment