What are the causes and treatments for infant respiratory distress syndrome?

Infant respiratory distress syndrome (RDS), commonly referred to as neonatal RDS, is most frequent in newborns delivered preterm.

When newborns are born prematurely, their lungs may not be fully formed, making breathing difficult. Without treatment, this can create short- and long-term difficulties. These may include irreversible lung damage, neurological delays, and death.

Below, we detail the symptoms, causes, and therapies of RDS in babies.

What is RDS?

Infant respiratory distress syndrome

RDS occurs in roughly 24,000 newborns in the United States yearly. It is more prevalent in newborns born preterm, whose lungs have not fully formed.

Infant RDS causes difficulties breathing. The indicators of this tend to show quickly after delivery or within a few minutes.

Causes

Infant RDS tends to affect newborns whose lungs have not fully formed before birth.

The lungs may have too little surfactant, a liquid covering that forms at around 20 weeksof gestation. As the fetus continues to grow, the lungs create more surfactant.

This liquid coats the tiny sacs of air in the lungs, keeping them from collapsing. The air sacs must remain open for oxygen to enter the blood and for the blood to expel carbon dioxide into the lungs.

A shortage of surfactant can cause an infant’s lungs to collapse, leading to difficulties breathing.

Symptoms

Infants born with RDS develop symptoms shortly after delivery or within minutes. Some typical signs of baby RDS include:

  • grunting
  • other unusual noises while breathing
  • flaring nostrils
  • a high respiratory rate, also called tachypnea
  • chest retractions, which may look as if the belly is pulling in beneath the ribs or breastbone

Risk factors
It is important mentioning that while RDS is more frequent in infants born prematurely, it can occur in any infant.

Some risk factors for infant RDS include:

  • being white
  • being male
  • having maternal diabetes
  • a lack of oxygen reaching the baby during labor and delivery
  • having restricted blood flow and oxygen
  • having a delivery in the absence of labor
  • having a low birth weight

Treatments

Healthcare providers use these tests to diagnose RDS in infants:

  • Arterial blood gas analysis. This can show whether oxygen levels in the blood are low and other related factors.
  • Chest radiography. This can show how the lungs have formed.
  • Various laboratory tests. These can rule out an infection and other possible causes of difficulty breathing.

RDS therapy generally begins with the transfer of the newborn to a neonatal intensive care unit, often known as the NICU, where they will receive constant medical observation and attention from professionals as they grow.

These specific therapeutic procedures are listed by the National Institutes of Health (NIH):

  • Surfactant replacement therapy. Infants with RDS may receive this until their lungs produce enough surfactant on their own.
  • Ventilator or nasal continuous positive airway pressure support. A machine provides breathing support until the lungs make enough surfactant.
  • Fluids and nutrients. These help the infant’s lungs develop.
  • Liquid intake checks. This is to make sure that fluid does not accumulate in the lungs.

Prevention

Premature birth, which occurs between 20 and 37 weeks of pregnancy, is the most effective approach to prevent infant RDS.

Preventing preterm delivery can be done in a variety of ways, including:

  • progesterone supplementation, for people with short cervixes
  • avoiding smoking during pregnancy
  • avoiding alcohol during pregnancy
  • avoiding recreational drugs during pregnancy

Outlook

Infants with RDS have a good outlook if they are diagnosed and treated immediately after birth. When therapy is started soon away, studies suggest a mortality rate of 2–10% in developed countries.

Long-term complications of RDS include:

  • damage to lung tissue, also called bronchopulmonary dysplasia
  • decreased clearance of fluid from the lung fluids
  • lung injury and inflammation
  • immature or irregular development of blood vessels, particularly in or around the lungs
  • neurodevelopmental delays

RDS can cause a serious deficiency of oxygen in the blood during the first few days of life if it is not treated. Multiple organ failure and death can occur as a result of this.

If a newborn is treated right away, his or her lungs will continue to develop and create enough surfactant. RDS normally resolves within 4–5 days in this situation. These babies typically require follow-up treatment but go on to enjoy healthy, normal lives.

Conclusion

Infant RDS is most common in premature babies who were born before their lungs had fully grown and had a liquid covering called surfactant. The lungs might collapse without surfactant, making breathing difficult.

The majority of RDS symptoms appear soon after birth. If therapy is started right away, the prognosis, and the problem may be resolved in 4–5 days.

Sources

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5516782/
  • https://www.medicalnewstoday.com/articles/infant-respiratory-distress-syndrome
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4237124/
  • https://www.nhlbi.nih.gov/health-topics/respiratory-distress-syndrome
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4533247/
  • https://www.ncbi.nlm.nih.gov/books/NBK560779/