Respiratory Distress Syndrome

The respiratory distress syndrome (formerly called hyaline membrane disease) is a respiratory disorder in which the alveoli (air sacs) in the lungs of newborn not remain open because of the high surface tension resulting from insufficient production of surfactant.

For a newborn baby is able to breathe independently, the alveoli should be able to remain open and filled with air after birth. They can do so in large part thanks to a substance called surfactant. The surfactant is produced by cells of pulmonary alveoli and reduce the surface tension. It is produced as the fetal lungs mature, often around the 34th week and almost always around the 37th week of pregnancy.

The respiratory distress syndrome occurs almost exclusively in premature newborns. The more premature the infant, the greater the chance of him presenting respiratory distress syndrome. The probability of occurrence of the syndrome is also higher in infants of diabetic mothers.
Prevention and Treatment

The risk of respiratory distress syndrome decreases considerably when delivery can be postponed until the fetal lungs have produced enough surfactant. When there is an imminent preterm birth can be carried out amniocentesis in order to collect a sample of amniotic fluid and estimate the concentration of the surfactant. When a doctor estimates that the fetal lungs are immature and that labor can not be postponed, he can administer a corticosteroid to the mother at least 24 hours before the estimated time of delivery. The corticosteroid crosses the placenta and reaches the fetus, stimulating your lungs to produce surfactant.

After birth, a newborn with respiratory distress syndrome may need to take only to be placed in an oxygen tent. Newborns with a more severe may require ventilatory support and surfactant treatment with a drug. A drug surfactant, which is very similar to natural surfactant can be dripped directly through a tube within the trachea of ​​the newborn. It increases the chance of survival by reducing the severity of respiratory distress syndrome and the risk of complications (eg, lung rupture). The drug can be administered surfactant immediately after birth to prevent respiratory distress syndrome in a very premature newborn who can develop it or can be administered as soon as the signs of the syndrome manifest.

The newborn is strictly monitored to ensure that the drug was administered surfactant is being tolerated and that breathing is improving. Treatments can be kept for several days, until the baby starts to produce its own surfactant.