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Respiratory distress syndrome (RDS) occurs in babies born early (premature) whose lungs are not fully developed. The earlier the infant is born, the more likely it is for them to have RDS and need extra oxygen and help breathing. RDS is caused by the baby not having enough surfactant in the lungs. Surfactant is a liquid made in the lungs at about 26 weeks of pregnancy. As the fetus grows, the lungs make more surfactant. Surfactant coats the tiny air sacs in the lungs and to help keep them from collapsing (Picture 1). The air sacs must be open to allow oxygen to enter the blood from the lungs and carbon dioxide to be released from the blood into the lungs. While RDS is most common in babies born early, other newborns can get it. Those at greater risk are:
Signs and SymptomsBabies who have RDS may show these signs:
DiagnosisThe diagnosis is made after examining the baby and seeing the results of chest X-rays and blood tests. TreatmentOxygen - Babies with RDS need extra oxygen. It may be given several ways:
Surfactant - Surfactant can be given into the baby’s lungs to replace what they do not have. This is given directly down the breathing tube that was placed in the windpipe. Intravenous (IV) catheter treatments - A very small tube called a catheter, is placed into one or two of the blood vessels in the umbilical cord. This is how the infant gets IV fluids, nutrition and medicines. It is also used to take blood samples. Medicines - Sometimes antibiotics are given if an infection is suspected. Calming medicines may be given to help ease pain during treatment. Warning
What to ExpectThe road to recovery is different for each infant. Often RDS gets worse before it gets better. Some babies need more oxygen than others. Some may require a treatment of surfactant. As the baby is able to breathe better, they may need less oxygen and other help to breathe. How to Know if Your Infant is Getting BetterHere are some signs that your baby is getting better. They will:
Respiratory Distress Syndrome (RDS) Newborn (PDF) HH-I-267 ©2011, Revised 2022, Nationwide Children’s Hospital What are the signs of respiratory distress in the newborn?Babies who have RDS may show these signs:. Fast breathing very soon after birth.. Grunting “ugh” sound with each breath.. Changes in color of lips, fingers and toes.. Widening (flaring) of the nostrils with each breath.. Chest retractions - skin over the breastbone and ribs pulls in during breathing.. What assessment finding is indicative of respiratory distress in newborns?The clinical presentation of respiratory distress in the newborn includes apnea, cyanosis, grunting, inspiratory stridor, nasal flaring, poor feeding, and tachypnea (more than 60 breaths per minute). There may also be retractions in the intercostal, subcostal, or supracostal spaces.
Which of the following would alert the nurse to the possibility of respiratory distress in a newborn?Rapid breathing. Grunting sounds with breathing. Ribs and breastbone pulling in when the baby breathes (chest retractions)
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