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Respiratory Distress Syndrome in Newborns

(Hyaline Membrane Disease; RDS)

Definition

Respiratory distress syndrome (RDS) is a lung disorder in newborns that causes problems breathing. It needs to be treated right away to avoid severe health problems.

Causes

RDS happens when an infant's lungs have not developed enough. Immature lungs lack a fluid called surfactant that helps the lungs open wide and take in air. The lungs do not open well without it. This makes it hard to breathe.
Respiratory System of an Infant
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Copyright © Nucleus Medical Media, Inc.

Risk Factors

RDS is more common in:
  • Babies who are born very early
  • Males
  • Babies born to mothers with diabetes
Other things that may raise the risk are:
  • Lack of oxygen during birth
  • The baby's blood entering the mother's circulation before or during delivery
  • Cesarean section delivery
  • Multiple birth
  • High blood pressure during pregnancy

Symptoms

Problems usually happen right after birth or within a few hours. They may be:
  • Rapid breathing
  • Pauses in breathing
  • Grunting noise with every breath
  • A chest that sinks in between the ribs or under the ribcage with each breath
  • Flaring of the nostrils
  • Blue color around the lips

Diagnosis

The doctor will ask about the mother's health history and pregnancy. A physical exam will be done on the baby. This is often enough to suspect RDS.
The diagnosis may be confirmed with a chest x-ray. Blood tests may also be done to check the baby's oxygen levels.

Treatment

The goal of treatment is to support and promote breathing. This can be done with:
  • Oxygen therapy or breathing support
  • Surfactant to help open the lungs
  • Inhaled nitric oxide to make it easier for oxygen to pass into the blood
  • Nutrition therapy with an IV or a feeding tube

Prevention

The risk of RDS may be lowered with regular prenatal care. This may help lower the chance of having a baby that is born too early.

RESOURCES

Healthy Children—American Academy of Pediatrics
http://www.healthychildren.org
Kids Health—Nemours Foundation
http://www.kidshealth.org

CANADIAN RESOURCES

About Kids Health—The Hospital for Sick Children
http://www.aboutkidshealth.ca
Health Canada
https://www.canada.ca

References

Respiratory distress syndrome (RDS) of the newborn. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/respiratory-distress-syndrome-rds-of-the-newborn-23 . Updated August 13, 2019. Accessed January 10, 2020.
Respiratory distress syndrome. The Merck Manual Professional Edition website. Available at: http://www.merckmanuals.com/professional/pediatrics/respiratory%5Fdisorders%5Fin%5Fneonates/respiratory%5Fdistress%5Fsyndrome.html. Updated August 13, 2019. Accessed January 10, 2020.
Sweet DG, Carnielli V, et al. European consensus guidelines on the management of neonatal respiratory distress syndrome in preterm infants - 2013 update. Neonatology. 2013;103(4):353-368.

Revision Information

  • Reviewer: EBSCO Medical Review Board Kari Kassir, MD
  • Review Date: 09/2019
  • Update Date: 01/13/2020
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