Hello and welcome to the Zero to Finals podcast.

My name is Tom and in this episode I'm going to be talking to you about respiratory distress syndrome.

And if you want to follow along with written notes on this topic,

you can follow along at zero tofinals.com slash RDS or in the neonatology section of the Zero to Finals pediatrics book. So let's get straight into it.

Respiratory distress syndrome affects premature neonates, born before the lungs start producing

adequate surfactant. Respiratory distress syndrome commonly occurs below 32 weeks gestational age, and chest x-ray findings

will show a ground glass appearance to the lung fields.

Let's start with some pathophysiology.

Inadequate surfactant leads to high surface tension within alveoli in the lungs.

This leads to atelectasis, which is lung collapse, as it is more difficult for the alveoli

and the lungs to expand. This leads to inadequate gases exchange resulting in hypoxia,

hypercapnia, which is a high CO2, and respiratory distress.

Management starts before the baby's born. Antinatal steroids, for example, dexamethasone,

can be given to mothers with suspected or confirmed preterm labour, aiming to increase the production

of surfactin and reduce the incidence and severity of respiratory distress syndrome in the baby.

Premature neonates may need intubation and ventilation to fully assist breathing if respiratory

distress is severe. Endotracheal surfactant, which is artificial surfactant delivered into the lungs via an endotracheal

tube.

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

breathing.

And supplementary oxygen to maintain oxygen saturations

between 91 and 95% in premature neonates. Support with breathing is gradually stepped down as the baby

...