Hi, this is Tom, and in this episode I'm going to be going through respiratory distress syndrome.

And you can find notes at zero to finals.com slash RDS or in the zero to finals pediatrics book.

And you can find flashcards and questions at members.com.

So let's jump straight in.

Respiratory distress syndrome affects premature neonates, particularly before 32 weeks gestation.

Let's start with the pathophysiology. Inadequate particularly before 32 weeks gestation.

Let's start with the pathophysiology.

Inadequate suffactant leads to high surface tension within alveoli.

It's more difficult for the alveoli and the lungs to expand, resulting in atelectasis, which is lung collapse.

There is inadequate gaseous exchange, causing hypoxia, or low oxygen, hypercapnia, which is high carbon dioxide, and respiratory distress.

A chest x-ray shows a ground glass appearance to the lung tissue.

Let's talk about management.

Cortico-steroids, for example intramuscular beta-metazone, are given to mothers with suspected or confirmed preterm labour, and these are used to increase suffactant production and reduce the incidence

and severity of respiratory distress syndrome.

Premature neonates may need endotracheal surfactant, which involves giving artificial

surfactant delivered into the lungs via an endotracheal tube.

Supplementary oxygen to maintain the oxygen saturations between 91 and 95% in preterm neonates,

continuous positive airway pressure or CPAP via a nasal mask to help keep the lungs inflated

while the neonate is breathing, and intubation and ventilation may

be required to fully assist breathing if the respiratory distress is severe.

Support with breathing is gradually stepped down as the baby develops and can maintain their own

breathing.

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