What Is Infant Respiratory Distress Syndrome?

Neonatal respiratory distress syndrome, also known as neonatal hyaline membrane disease. Refers to symptoms such as progressive dyspnea and respiratory failure that occur shortly after birth. It is mainly caused by the lack of alveolar surfactants, leading to progressive alveolar collapse. The child has progressive breathing within 4 to 12 hours after birth. Difficulty, groaning, cyanosis, and inhalation tricuspid signs, severe cases of respiratory failure. Incidence is related to gestational age. The smaller the gestational age, the higher the incidence, the lower the weight and the higher the mortality.

Basic Information

nickname

Neonatal hyaline membrane disease

Visiting department

Pediatrics

Multiple groups

premature baby

Common causes

Caused by lack of alveolar surfactant

Common symptoms

Progressive dyspnea, moaning, cyanosis, inhalation tricuspid sign, severe respiratory failure

Causes of neonatal respiratory distress syndrome

Mainly due to the lack of alveolar surfactants, leading to progressive alveolar collapse.

Clinical manifestations of neonatal respiratory distress syndrome

Most of the infants are premature babies. Crying sounds can be normal at birth. Breathing difficulties occur within 6 to 12 hours, and they gradually increase with moaning. Breathing irregularly with occasional apnea. The complexion becomes gray or gray due to hypoxia, and the bluish purple is obvious after right-to-left shunting, which cannot be alleviated by oxygen supply. Muscle tension in the extremities is low in severe hypoxia. The signs include nasal fan movement, thoracic bulge at the beginning, and atelectasis will increase later, and the thoracic sag will follow. The soft tissue of the thorax is indented during inhalation, most notably below the costal margin and at the lower end of the sternum. Lung breathing sounds are reduced and a fine wet snoring sound can be heard when inhaling. This disease is a self-limiting disease. Those who can survive for more than three days have increased lung maturity and have greater hope for recovery. However, many infants have pneumonia, which makes the condition worsen and improves after infection control. Most severely ill infants die within three days, with the highest mortality rate the day after birth.

This disease is also mild. It may be caused by a lack of surface-active substances. The onset is late, it can be as late as 24 to 48 hours, the breathing is light, no moaning, and cyanosis is not obvious.

Newborn respiratory distress syndrome examination

Blood biochemical examination

PaCO ₂ increased due to low hypoventilation PaO ₂ . Because the pH of the metabolic acidosis blood is lowered, regular arterial blood testing is required. During metabolic acidosis, the residual alkali is reduced, and the binding capacity of carbon dioxide is decreased. Blood is prone to produce low Na, K, and high Cl during disease, so blood electrolytes need to be measured.

2. X-ray performance

In the early stages of the transparent membrane of the lung, the general transparency of the lung fields on both sides was generally reduced, with uniformly distributed fine particles and reticular shadows. The small particles represented small atelects of the alveoli and the reticular shadows represented congested small blood vessels. The bronchi have signs of inflation, but they are easily obscured by the shadows of the heart and thymus.

Treatment of neonatal respiratory distress syndrome

Prenatal single-course application of hormones has a preventive effect on neonatal respiratory distress syndrome. Surfactant replacement therapy is essential in the management of neonatal respiratory distress syndrome. Mechanical ventilation, a form of respiratory support, can save the lives of children. Strategies should use continuous nasal positive airway pressure or nasal ventilation as much as possible, and avoid mechanical ventilation as much as possible; in order to obtain the best prognosis for neonatal respiratory distress syndrome, good supportive treatment must be given, including maintaining normal body temperature , Proper humoral therapy, good nutritional support, management of open arterial ducts, and circulatory support to maintain proper tissue perfusion.