V Respiratory distress syndrome (hyaline

membrane disease) is a breathing disorder of

premature newborns in which the air sacs
(alveoli) in a newborn's lungs do not remain
open because the production of a substance
that coats the alveoli (surfactant) is absent
or insufficient.
V 2eonatal RDS occurs in infants whose lungs have not yet
fully developed.
V The disease is mainly caused by a lack of a slippery,
protective substance called surfactant, which helps the
lungs inflate with air and keeps the air sacs from
collapsing. This substance normally appears in mature
lungs.
V It can also be the result of genetic problems with lung
development.
V The earlier a baby is born, the less developed the lungs
are and the higher the chance of neonatal RDS. Most
cases are seen in babies born before 28 weeks. It is very
uncommon in infants born full-term (at 40 weeks).
V  brother or sister who had RDS
V Diabetes in the mother
V Cesarean delivery
V Delivery complications that lead to acidosis in
the newborn at birth
V Multiple pregnancy (twins or more)
V Rapid labor
V The risk of neontal RDS may be decreased if the
pregnant mother has chronic, pregnancy-related
high blood pressure or prolonged rupture of
membranes, because the stress of these
situations cause the infant's lungs to mature
sooner.
V The symptoms usually appear within minutes of birth,
although they may not be seen for several hours.
Symptoms may include:
V Bluish color of the skin and mucus membranes (cyanosis)
V Brief stop in breathing (apnea)
V Decreased urine output
V Grunting
V 2asal flaring
V Puffy or swollen arms or legs
V Rapid breathing
V Shallow breathing
V Shortness of breath and grunting sounds while breathing
V Unusual breathing movement -- drawing back of the chest
muscles with breathing
V  blood gas analysis shows low oxygen and excess
acid in the body fluids.
V  chest x-ray shows respiratory distress. The
lungs have a characteristic "ground glass"
appearance, which often develops 6 to 12 hours
after birth. Lung function studies may be
needed.
V Lab tests are done to rule out infection and
sepsis as a cause of the respiratory distress.
V 4igh-risk and premature infants require prompt
attention by a neonatal resuscitation team.
V Despite greatly improved RDS treatment in
recent years, many controversies still exist.
Delivering artificial surfactant directly to the
infant's lungs can be enormously important, but
how much should be given and who should
receive it and when is still under investigation.
V Infants will be given warm, moist oxygen. This is
critically important, but needs to be given
carefully to reduce the side effects associated
with too much oxygen.
A breathing machine can be lifesaving, especially
for babies with the following:

V 4ighlevels of carbon dioxide in the arteries

V Low blood oxygen in the arteries
V Low blood p4 (acidity)
V  treatment called continuous positive airway pressure
(CPP) that delivers slightly pressurized air through the
nose can help keep the airways open and may prevent
the need for a breathing machine for many babies. Even
with CPP, oxygen and pressure will be reduced as soon
as possible to prevent side effects associated with
excessive oxygen or pressure.

V  variety of other treatments may be used, including:

V Extracorporeal membrane oxygenation (ECMO) to

directly put oxygen in the blood if a breathing machine
can't be used
V Inhaled nitric oxide to improve oxygen levels
V It is important that all babies with RDS
receive excellent supportive care, including
the following, which help reduce the infant's
oxygen needs:
V Few disturbances
V Gentle handling
V Maintaining ideal body temperature
V Infants with RDS also need careful fluid
management and close attention to other
situations, such as infections, if they
develop.
V 1. What does 4IV stands for?
V 2. 4ow do newborn babies get 4IV?
V 3. Respiratory Distress Syndrome also known as?
V 4. What does CPP stands for
V 5. Give 1 preventive tip to prevent SIDS?
V 6. T or F- Is it ok for a 4IV mother to breastfeed her baby?
V 7. State one common test performed on premature infant
V 8.State one different pregnancy related problems that
increases the risk of preterm labor.
V 9. Give 1 risk for developing Transient Tachypnea of the
2ewborn.
V 10. State the reason why there is a need to give Vitamin K
to newborn babies.