Respiratory distress syndrome - pathophysiology, clinical features, prevention, treatment

Respiratory Distress Syndrome (RDS), also known as infant respiratory distress syndrome (IRDS) or hyaline membrane disease, is a condition primarily affecting premature infants. It is characterized by difficulty in breathing due to underdeveloped or insufficient surfactant in the lungs. Surfactant is a substance that helps keep the air sacs in the lungs open, allowing for proper oxygenation. Key features of Respiratory Distress Syndrome include: 1. *Prematurity:* RDS is most commonly seen in premature infants, especially those born before 28 weeks of gestation. Surfactant production typically begins in the third trimester of pregnancy, and premature babies may not have enough of it. 2. *Symptoms:* Infants with RDS may exhibit signs of respiratory distress shortly after birth. Symptoms include rapid and shallow breathing, flaring nostrils, retractions (visible sinking of the chest between the ribs or under the ribcage), and a bluish tint to the skin (cyanosis) due to inadequate oxygen levels. 3. *Diagnosis:* Diagnosis is often based on clinical signs and a chest X-ray that reveals a "ground glass" appearance, indicating a lack of air in the lungs and the presence of a hyaline membrane. 4. *Treatment:* The primary treatment for RDS is supportive care. Infants may require supplemental oxygen and mechanical ventilation to help them breathe. Exogenous surfactant can also be administered to improve lung function. 5. *Complications:* Premature infants with RDS are at risk of developing complications such as bronchopulmonary dysplasia (BPD), a chronic lung disease, as well as intraventricular hemorrhage (IVH) and other issues related to prematurity. 6. *Prevention:* The best prevention for RDS is to avoid premature birth. In cases where premature birth is anticipated, administering corticosteroids to the mother before delivery can help accelerate lung maturation in the fetus and reduce the risk of RDS. RDS is a serious condition that requires prompt medical attention, and the prognosis can vary depending on the severity of the disease and the overall health of the infant. Advances in neonatal care, including surfactant replacement therapy and improved respiratory support techniques, have significantly improved the outcomes for infants with RDS.