Hyaline Membrane Disease, also known as Respiratory Distress Syndrome (RDS), affects newborns, particularly those born prematurely. This condition is characterized by a coating of proteins and dead cells lining the tiny air sacs in the lungs, which impedes or prevents normal breathing. The term "hyaline" is derived from the Greek "hyalos," meaning "glass" or "transparent stone," reflecting the glassy appearance of the membrane.RDS is primarily due to a lack of surfactant, a critical molecule composed of phospholipids and lipoproteins, secreted by lung cells. This substance helps maintain the alveoli's function by reducing surface tension. Without adequate surfactant, the alveoli may collapse, making lung expansion more difficult. Premature infants, especially those born before 37 weeks, are at a heightened risk, with the condition being more common in infants born to diabetic mothers.In RDS, the insufficient surfactant leads to decreased lung compliance, increasing the effort required to breathe. The underdeveloped ribcage of preterm infants further complicates breathing, resulting in deep chest retractions with poor air intake. This can cause widespread lung collapse (atelectasis). Symptoms often manifest as rapid, labored breathing, nasal flaring, and retractions around the breastbone shortly after birth. The severity of lung collapse and respiratory failure tends to worsen progressively.While not all infants with RDS display signs of distress, those with extremely low birth weight (under 1000 grams) may be unable to breathe at birth due to severely stiff lungs. To mitigate the risk of RDS, assessing fetal lung maturity can help determine the best time for delivery. Administering betamethasone to the mother at least 24 hours before a premature birth can stimulate fetal surfactant production and reduce RDS risk or its severity.If left untreated, severe RDS can lead to multiple complications and potentially death. However, with adequate respiratory support, surfactant production usually begins, and RDS can resolve within 4 to 5 days. Recovery is often accelerated by administering pulmonary surfactant treatments.
