Respiratory distress syndrome (RDS), which used to be called hyaline membrane disease, is one of the most common problems of premature babies. It can cause babies to need extra oxygen and help breathing. The course of illness with respiratory distress syndrome depends on the size and gestational age of the baby, the severity of the disease, the presence of infection, whether or not a baby has a patent ductus arteriosus (a heart condition), and whether or not the baby needs mechanical help to breathe. RDS typically worsens over the first 48 to 72 hours, then improves with treatment. Show
RDS occurs when there is not enough of a substance in the lungs called surfactant. Surfactant is a liquid produced by the lungs that keeps the airways (called alveoli) open, making it possible for babies to breathe in air after delivery. It begins to be produced in the fetus at about 26 weeks of pregnancy. When there is not enough surfactant, the tiny alveoli collapse with each breath. As the alveoli collapse, damaged cells collect in the airways and further affect breathing ability. The baby works harder and harder at breathing, trying to reinflate the collapsed airways. As the baby's lung function decreases, less oxygen is taken in and more carbon dioxide builds up in the blood. This can lead to increased acid in the blood called acidosis, a condition that can affect other body organs. Without treatment, the baby becomes exhausted trying to breathe and eventually gives up. A mechanical ventilator (breathing machine) must do the work of breathing instead. RDS occurs most often in babies born before 28 weeks gestation. Some premature babies develop RDS severe enough to need a mechanical ventilator (breathing machine). The more premature the baby, the higher the risk and the more severe the RDS. Although most babies with RDS are premature, other factors can influence the chances of developing the disease. These include the following:
The following are the most common symptoms of RDS. However, each baby may experience symptoms differently. Symptoms may include:
The symptoms of RDS usually peak by the third day, and may resolve quickly when the baby begins to diurese (excrete excess water in urine). When a baby improves, he or she begins to need less oxygen and mechanical help to breathe. The symptoms of RDS may resemble other conditions or medical problems. Always consult your baby's doctor for a diagnosis. RDS is usually diagnosed by a combination of assessments, including the following:
Specific treatment for RDS will be determined by your baby's doctor based on:
Treatment for RDS may include:
Babies with RDS sometimes develop complications of the disease or problems as side effects of treatment. As with any disease, more severe cases often have greater risks for complications. Some complications associated with RDS include the following:
Preventing a preterm birth is the primary means of preventing RDS. When a preterm birth cannot be prevented, giving the mother medications called corticosteroids before delivery has been shown to dramatically lower the risk and severity of RDS in the baby. These steroids are often given to women between 24 and 34 weeks gestation who are at risk of early delivery. However, if the delivery is very quick or unexpected, there may not be time to give the steroids, or they may not have a chance to begin working. What steps should be taken as part of the initial management of a child in respiratory distress?General BREATHING Interventions:. Monitor the oxygen saturation level using non-invasive pulse oximetry.. Administer oxygen and titrate to keep the oxygen saturation > 94%. ... . Provide assisted ventilations using a bag-valve mask device.. Administer inhaled medications to help improve breathing.. What is an initial measure that you can perform to maintain his airway?In airway management, we start simple. What's the simplest thing we can do to maintain patency of that airway. It may just be the head-tilt-chin lift or head-tilt-chin lift with an oral airway. If that doesn't work then we have to move to an advanced airway.
What is the first priority in managing lower airway obstruction pals?Emergency Management. In any case of respiratory distress, the first priority is to ensure an adequate airway. Most children who present with asthma will come in some degree of distress; however, most are able to be treated without intubation. A good physical examination and a brief history are essential.
Which interventions may be included in the management of disordered control of breathing due to increased intracranial pressure?Medical management of increased intracranial pressure should include sedation, drainage of cerebrospinal fluid, and osmotherapy with either mannitol or hypertonic saline.
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