RESPIRATORY DISTRESS SYNDROME (HYALINE MEMBRANE
Respiratory distress syndrome (RDS) is characterized by a progressive and
frequently fatal respiratory disorder resulting from atelectasis and immaturity of the
a. Incidence. Respiratory distress syndrome occurs almost exclusive in
infants born before the 37th week of gestation. It occurs more often in infants of
diabetic mothers, those delivered by cesarean section, and those delivered suddenly
after antepartum hemorrhage. This disease is the most common cause of neonatal
mortality. In the US alone, it causes death of 40,000 newborns every year.
b. Cause. Although the airways and alveoli of an infant's respiratory system
are present by the 27th week of gestation, the intercostal muscles are weak and the
alveoli and capillary blood supply is immature. In RDS, the premature infant develops
widespread alveolar collapse because of lack of surfactant.
c. Signs and Symptoms.
May breathe normally at first.
Rapid, shallow respirations, then prolonged apnea.
Intercostal, subcostal, or sternal retractions.
(5) Audible expiratory grunting. A natural compensatory mechanism
designed to produced positive end-expiratory pressure and prevent further alveolar
Low body temperature.
NOTE: Early diagnosis is imperative so that treatment may begin immediately.
Vigorous respiratory support.
(2) Warm, humidified, oxygen-enriched gases are administered by oxygen
hood which is the treatment of choice.