Respiratory Distress Syndrome (RDS), once referred to by a different name, is a condition in newborns characterized by breathing difficulties due to a lack of a crucial molecule. This syndrome predominantly affects infants born before 37 weeks of gestation, with increasing likelihood as prematurity increases. The risk is also heightened in newborns of mothers with diabetes.Surfactant, composed of phospholipids and lipoproteins, is released by lung cells. It plays a vital role in maintaining the air-fluid balance on the thin water film lining the lungs, where oxygen and carbon dioxide exchange occurs. Without adequate surfactant, strong forces lead to the collapse of alveoli, reducing lung compliance and increasing the effort required to inflate the stiff lungs. Premature infants face additional challenges as their ribs are more pliable, leading to marked sternal retractions but inadequate air intake if ribs are more compliant than the lungs, resulting in widespread lung collapse (atelectasis).Typically, rapid, labored breathing with grunting noises begins right after birth or within a few hours, accompanied by retractions around the breastbone and nostril flaring. The severity of lung collapse and respiratory failure tends to worsen over time. Some infants with RDS may exhibit no respiratory distress signs; those with extremely low birth weights (under 1000 grams) may struggle to breathe at birth due to extremely stiff lungs, potentially failing to breathe in the delivery room.Reducing the incidence of RDS involves assessing fetal lung maturity to determine the best time for delivery. When early delivery is necessary, administering betamethasone to the mother at least 24 hours prior encourages fetal surfactant production, decreasing the likelihood or severity of RDS.Without treatment, severe RDS can lead to multiple complications and even death. However, with adequate support for the newborn, surfactant production begins, and RDS typically resolves within four to five days. Recovery is accelerated by administering pulmonary surfactant.
