RT 256

Idiopathic (Infant) Respiratory Distress Syndrome

IRDSAlso Called: Pathophysiologyneonatal

respiratory distress syndrome

respiratory distress syndrome of newborn

hyaline membrane disease

Surfactant deficiency or abnormality

Pulmonary hypoperfusion due to hypoxia PPHN

EtiologyPredisposed in:

Cesarean birthDiabetic motherMaternal bleedingPremature birthPrenatal asphyxiaProlonged labor or Rapid laborSecond-born twin or sibling with IRDScaucasian males

PresentationClinical signs of respiratory distressABG’s show hypoxemia, hypercapnia and

respiratory acidosisSymptoms within the first 8 hours of lifePeak usually by third day“ground glass” appearance of the CXR

ManagementAntenatal

glucocorticoids (steroids)

Surfactant replacement therapy

Empiric antibiotic therapy

Thermoregulation

Avoid hypoxemia and acidosisPaO2 50-70mmHg

Optimize fluid management

Reduce metabolic demands

Minimize lung injuryCPAPVt 4-5ml/kgPEEP