Neonatal Respiratory Distress Syndrome - Dr. Kalpesh Patil

Neonatal Respiratory Distress Syndrome:

Neonatal respiratory distress syndrome (NRDS) occurs when the baby's lungs are not fully developed and cannot supply enough oxygen, causing respiratory problems. It usually affects premature babies.

It's otherwise called infant respiratory distress syndrome, hyaline membrane disease, or surfactant insufficiency lung disease. Regardless of having a comparable name, NRDS isn't identified with intense acute respiratory distress syndrome (ARDS). Dr. Kalpesh Patil is one of the Best Pediatrician in Pune who is highly experienced in this field.  

Why does it happen?

NRDS for the most part happens when the baby’s lungs have not produced enough surfactant.

Composed of protein and fat, this substance keeps the lungs swelling and prevents them from collapsing. A baby ordinarily starts producing surfactants at some point between weeks 24 and 28 of pregnancy. Most babies breathe normally by 34 weeks. If your baby is born prematurely, you may not have enough surfactant in your lungs. NRDS can affect babies who are not preterm.

For instance, when:

• The baby is underweight
• The baby's lungs did not develop properly
• The mother has diabetes

Approximately half of all babies born between the 28th and 32nd week of pregnancy develop NRDS.

Recently, the use of steroid injections that can be given to mothers during preterm birth has reduced the number of premature babies born with NRDS.

What are the Symptoms of NRDS?

The indications of NRDS are regularly observable following birth and deteriorate over the accompanying not many days.

They can include:

• Blue-colored lips, fingers, and toes
• Rapid, shallow breathing
• Flaring nostrils
• A grunting sound when breathing

Diagnosing NRDS:

Various tests can be utilized by doctors to analyze NRDS and preclude other potential causes.

These include:

• A physical assessment
• Blood tests to measure the amount of oxygen in the baby’s blood and check for a disease
• A heartbeat oximetry test to measure how much oxygen is in the baby’s blood utilizing a sensor attached to at the tip of their finger, ear, or toe
• A chest X-Ray to search for the distinctive appearance of the lungs in NRDS

Treating NRDS:

The primary point of treatment for NRDS is to assist the baby with breathing.

Treatment before birth

If there is a risk of administration 34 weeks before pregnancy, treatment with NRDS may be started before birth. You might have a steroid infusion before your baby is delivered. A second dose is typically given 24 hours after the first.

The steroids stimulate the advancement of the baby’s lungs. It's assessed that the treatment prevents NRDS in 33% of premature births. You may likewise be offered magnesium sulfate to lessen the risk of developmental issues connected to being born early.

On the off chance that you take magnesium sulfate for more than 5 to 7 days or a few times during your pregnancy, your baby might be offered additional checks. This is on the grounds that delayed utilization of magnesium sulfate in pregnancy has in uncommon cases been linked to bone issues in newborn babies.

Treatment after the birth

Your baby might be transferred to a ward that gives expert consideration to premature babies (a neonatal unit). If the symptoms are mild, additional oxygen may be needed. It is usually given by an incubator, a small mask on the nose or face, or a tube of the nose. In case symptoms are more serious, your baby will be attached to a breathing machine (ventilator) to one or the other to help or assume control over their breathing. These treatments are started regularly in the maternity ward before being transferred to the neonatal ward.

Your baby may likewise be given a dose of artificial surfactant, for the most part through a breathing tube. Evidence proposes early treatment within 2 hours of delivery is more advantageous than if treatment is postponed. They'll likewise be given fluids and nutrition through a tube associated with a vein.

A few babies with NRDS just need help with breathing for a couple of days. In any case, a few, generally those born extremely prematurely, may require support for quite a long time or even months. Premature babies frequently have multiple issues that keep them in the emergency clinic, yet for the most part, they're all right to return home around their expected delivery date. The timeframe your baby needs to remain in the clinic will rely upon how early they were born.

What are the Complications of NRDS?

Most babies with NRDS can be effectively treated, even if they are at high risk of developing further problems in the future.

• Air Leaks: Air can here and there spill out of the baby’s lungs and become trapped in their chest cavity. This is known as a pneumothorax. The pocket of air puts additional pressure on the lungs, making them collapse and prompting extra breathing issues. Air leaks can be treated by inserting a tube into the chest to permit the trapped air to escape.
• Internal Bleeding: Babies with NRDS may have bleeding in the lungs (pulmonary hemorrhage) and brain (cerebral hemorrhage). Pulmonary hemorrhage is treated with air pressure from a ventilator to stop bleeding and blood transfusions. Cerebral hemorrhage occurs very often in premature babies, but most bleeding is mild and does not cause long-term problems.
• Lung scarring: Here and there, ventilation (starting within 24 hours after birth) or surfactants to treat NRDS scars in the baby's lungs are affected, which affects their development. These scars are called bronchopulmonary dysplasia (BPD). Indications of BPD incorporate fast, shallow breathing and shortness of breath. Babies with severe BPD usually need extra oxygen from a tube that goes into the nose to help breath. This is typically stopped following a couple of months when the lungs have healed. Yet, children with BPD might require regular medication, like bronchodilators, to assist widen their airways and make breathing easier.
• Developmental inabilities: In case the baby’s brain is damaged during NRDS, either due to bleeding or an absence of oxygen, it can prompt long-term developmental inabilities, like learning difficulties, movement issues, impaired hearing, and impaired vision. However, these developmental issues are not typically serious. For instance, 1 survey assessed that 3 out of 4 kids with developmental issues just have a mild inability, which ought not to prevent them from leading a normal adult life.