Contents
RESPIRATORY DISTRESS SYNDROME
[pathogenesis, clinical features, and management and prevention ]
- Aka HYALINE MEMBRANE DISEASE
- Incidence-
- Overall: 10 to 15%
- in < 28weeks of gestation: 80%
- Risk factors: Prematurity, asphyxia, acidosis, maternal diabetes, C-section
I. ETIOPATHOGENESIS
- Normally:
Type 2 alveolar cells -> produce surfactant -> helps reduce surface tension
In RDS: Basic abnormality is surfactant deficiency.
Pathogenesis Of Respiratory Distress Syndrome/ Hyaline Membrane Disease
Surfactant deficiency -> alveoli collapse -> ventilation perfusion mismatch -> hypoxia and acidosis -> pulmonary vasoconstriction -> alveolar hypoperfusion -> ischaemic damage to alveoli -> transudation of proteins in alveoli -> form hyaline membrane
- Surfactant production
- Starts around: 20 weeks
- Peak: 35 weeks
- That’s why any neonate <35week is prone to develop RDS
II. CLINICAL FEATURES
- Occur within 1st 6 hours of life
- Clinical Features:
- Tachpnoea
- Retraction
- Grunting
- Cyanosis
- DECREASED air entry
- Radiological feature
- Retinogranular pattern
- Ground glass opacity[mcQ]
- Low lung volume
- Air bronchogram[mcQ]
- In severe disease- White out lungs
III. MANAGEMENT
- SUSPECTED Respiratory Distress Syndrome : Cared in NICU with IV fluids & Oxygen
- MILD to MODERATE Respiratory Distress Syndrome: Managed with CPAP [Continuous distending pressure of 5-7cm of water applied at the level of nostrils to keep alveoli open in spontaneously breathing baby]
- SEVERE Respiratory Distress Syndrome: Require mechanical ventilation
- InSurE approach
- INtubated
- SURfactant given
- Extubated rapidly to CPAP
TREATMENT OF CHOICE– Exogenous surfactant
Indication- Moderate to severe RDS + Prophylaxis (all neonates <28weeks)
Route of administration- INTRATRACHEAL
Also Download:
- [pdf] Hutchinsons Clinical Manual of medicine free download pdf
- Subject wise Books for NEET- PG Exam Preparation
- [pdf] Arup Kumar Kundu clinical Medicine download pdf
IV. PREVENTION
- Antenatal steroids given to mother in preterm labor (<35weeks)
- induce phospholipid synthesis and release of surfactant
- Enhance lung maturation process
- Betamethasone phosphate OR acetate (6mg) administered 24-72 hours prior to delivery
Also Download :
- [Pediatrics] Handwritten Notes by DAMS teachers download pdf
- [Medicine] Handwritten Notes for NEET PG ( from DAMS teachers) free download
- Dr Thameem Medicine Notes for NEET PG
This is all you Need to Know About Hyaline Membrane Disease or Respiratory Distress Syndrome for NEET PG or Your Pediatrics in Final Year MBBS.
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