Respiratory distress syndrome (RDS)

Formerly known as hyaline membrane disease, a syndrome of respiratory difficulty in newborn infants caused by a deficiency of a molecule called surfactant.

RDS almost always occurs in newborns born before 37 weeks of gestation. The more premature the baby is, the greater is the chance of developing RDS. RDS is more likely to occur in newborns of diabetic mothers.

Surfactant, a mixture of phospholipids and lipoproteins, is secreted by lung cells. The air-fluid interface of the film of water lining the alveoli of the lung (where the exchange of oxygen and CO2 occurs) exerts large forces that cause the alveoli to close if surfactant is deficient. Lung compliance is decreased, and the work of inflating the stiff lungs is increased. The preterm newborn is further handicapped because his or her ribs are more easily deformed (compliant). Breathing efforts therefore result in deep sternal (breastbone) retractions but poor air entry if the ribs are compliant compared with the lungs. This results in diffuse atelectasis (collapse of the lungs).

Rapid, labored, grunting respirations usually develop immediately or within a few hours after delivery, with retractions above and below the breastbone and flaring of the nostrils. The extent of atelectasis (lung collapse) and the severity of respiratory failure progressively worsen.

Not all infants with RDS have signs of respiratory distress; extremely low birth weight newborns (i.e., < 1000 g) may be unable to initiate respirations at birth because their lungs are so stiff; they may fail to initiate breathing in the delivery room. The incidence of RDS can be reduced by assessment of fetal lung maturity to determine the optimal time for delivery. When a fetus must be delivered prematurely, giving betamethasone systemically to the mother for at least 24 hours before delivery induces fetal surfactant production and usually reduces the risk of RDS or decreases its severity. If untreated, severe RDS can result in multiple organ failure and death. However, if the newborn's ventilation is adequately supported, surfactant production will begin and RDS will resolve by 4 or 5 days. Recovery is hastened by treatment with pulmonary surfactant.

Read Also:

  • Respiratory distress syndrome, acute

    Respiratory failure of sudden onset due to fluid in the lungs (pulmonary edema), following an abrupt increase in the permeability of the normal barrier between the capillaries in the lungs and the air sacs. The muscles used in breathing are forced to work harder, causing labored and inefficient breathing. An abnormally low level of oxygen […]

  • Respiratory failure

    Inability of the lungs to perform their basic task of gas exchange, the transfer of oxygen from inhaled air into the blood and the transfer of carbon dioxide from the blood into exhaled air. Respiratory failure occurs because of the failure of the exchange of oxygen and carbon dioxide in tiny air sacs in the […]

  • Respiratory insufficiency

    The condition in which the lungs cannot take in sufficient oxygen or expell sufficient carbon dioxide to meet the needs of the cells of the body. Also called pulmonary insufficiency.

  • Respiratory papillomatosis, recurrent

    Recurrent respiratory papillomatosis involves the growth of numerous warty growths in the larynx on the vocal cords in children and young adults. A baby can contract recurrent respiratory papillomatosis by being contaminated with the human papilloma virus (HPV) during birth through the vaginal canal of a mother with genital warts (which are also due to […]

  • Respiratory rate

    The number of breaths per minute or, more formally, the number of movements indicative of inspiration and expiration per unit time. In practice, the respiratory rate is usually determined by counting the number of times the chest rises or falls per minute. The aim of measuring respiratory rate is to determine whether the respirations are […]

Disclaimer: Respiratory distress syndrome (RDS) definition / meaning should not be considered complete, up to date, and is not intended to be used in place of a visit, consultation, or advice of a legal, medical, or any other professional. All content on this website is for informational purposes only.