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Respiratory distress syndrome (RDS) occurs in babies born early (premature) whose lungs are not fully developed. The earlier the infant is born, the more likely it is for them to have RDS and need extra oxygen and help breathing. RDS is caused by the baby not having enough surfactant in the lungs. Surfactant is a liquid made in the lungs at about 26 weeks of pregnancy. As the fetus grows, the lungs make more surfactant. Surfactant coats the tiny air sacs in the lungs and to help keep them from collapsing (Picture 1). The air sacs must be open to allow oxygen to enter the blood from the lungs and carbon dioxide to be released from the blood into the lungs. While RDS is most common in babies born early, other newborns can get it. Those at greater risk are:
Signs and SymptomsBabies who have RDS may show these signs:
DiagnosisThe diagnosis is made after examining the baby and seeing the results of chest X-rays and blood tests. TreatmentOxygen - Babies with RDS need extra oxygen. It may be given several ways:
Surfactant - Surfactant can be given into the baby’s lungs to replace what they do not have. This is given directly down the breathing tube that was placed in the windpipe. Intravenous (IV) catheter treatments - A very small tube called a catheter, is placed into one or two of the blood vessels in the umbilical cord. This is how the infant gets IV fluids, nutrition and medicines. It is also used to take blood samples. Medicines - Sometimes antibiotics are given if an infection is suspected. Calming medicines may be given to help ease pain during treatment. Warning
What to ExpectThe road to recovery is different for each infant. Often RDS gets worse before it gets better. Some babies need more oxygen than others. Some may require a treatment of surfactant. As the baby is able to breathe better, they may need less oxygen and other help to breathe. How to Know if Your Infant is Getting BetterHere are some signs that your baby is getting better. They will:
Respiratory Distress Syndrome (RDS) Newborn (PDF) HH-I-267 ©2011, Revised 2022, Nationwide Children’s Hospital What steps should be taken as part of initial management of a child in respiratory distress?General BREATHING Interventions:. Monitor the oxygen saturation level using non-invasive pulse oximetry.. Administer oxygen and titrate to keep the oxygen saturation > 94%. ... . Provide assisted ventilations using a bag-valve mask device.. Administer inhaled medications to help improve breathing.. What is an initial measure that you can perform to maintain his airway?In airway management, we start simple. What's the simplest thing we can do to maintain patency of that airway. It may just be the head-tilt-chin lift or head-tilt-chin lift with an oral airway. If that doesn't work then we have to move to an advanced airway.
Which interventions may be included in the management of disordered control of breathing due to increased intracranial pressure?Medical management of increased intracranial pressure should include sedation, drainage of cerebrospinal fluid, and osmotherapy with either mannitol or hypertonic saline.
What sequence is used when caring for seriously ill or injured child to help determine the best treatment or intervention?Use the evaluate-identify-intervene sequence when caring for a seriously ill or injured child. Evaluate the child to gather information about the child's condition or status. Identify any problem by type and severity. Intervene with appropriate actions to treat the problem.
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