What do Doctors call this Condition - Respiratory distress syndrome, hyaline membrane disease

What is this Condition?

Infant respiratory distress syndrome is the most common cause of death in newborns. In the United States alone, it kills 40,000 new­borns every year. The syndrome occurs in premature infants and, if untreated, is fatal within 72 hours of birth in up to 14% of infants weighing less than 5½ pounds (2,500 grams). Aggressive management using mechanical ventilation can improve the prognosis, but a few infants who survive have lung problems. Mild infant respiratory distress syndrome slowly subsides after 3 days.

What Causes it?

Infant respiratory distress syndrome occurs almost exclusively in infants born before the 37th week of development (60% of those born before the 28th week). It occurs more often in infants of diabetic mothers, those delivered by cesarean section, and those delivered suddenly after antepartum hemorrhage.

Although the breathing passages and alveoli (air sacs in the lungs) of an infant’s respiratory system are present by the 27th week of gestation, the chest muscles are weak and the alveoli and capillary blood supply are immature. In respiratory distress syndrome, the premature infant develops widespread alveolar collapse due to lack of a substance called surfactant. This deficiency prevents the lungs from expanding and causes oxygen deficiency.

What are its Symptoms?

While an infant with respiratory distress syndrome may breathe normally at first, he or she usually develops rapid, shallow respirations within minutes or hours of birth, with chest retractions, flaring nostrils, and audible grunting upon exhaling. The infant may also display low blood pressure, fluid retention, and decreased urine output. In severe disease, symptoms include absence of breathing, slow heart rate, and bluish skin discoloration.

How is it Diagnosed?

While signs of respiratory distress in a premature infant during the first few hours of life strongly suggest respiratory distress syndrome, a chest X-ray and arterial blood gas analysis are necessary to confirm the diagnosis.

When a cesarean section is necessary before the 36th week of development, amniocentesis helps to assess prenatal lung development and, thus, the risk of infant respiratory distress syndrome.

How is it Treated?

Treating a newborn with infant respiratory distress syndrome requires vigorous respiratory support. Warm, humidified, oxygenen­riched gases are given by oxygen hood or, if such treatment fails, by mechanical ventilation. Treatment also includes:

• a radiant infant warmer or isolette for regulation of body temperature

• intravenous fluids

• tube feedings or total parenteral nutrition if the infant is too weak to eat

• administration of surfactant by an endotracheal tube.

What can the parents of an Infant with Respiratory Distress Syndrome do?

• Learn about your infant’s condition and, if possible, participate in care to promote normal parent-infant bonding .

• Be aware that full recovery may take up to 12 months.