Respiratory Distress Syndrome Health Article

Prevention

The best way of preventing RDS is to delay delivery until the fetal lungs have matured and are producing enough surfactant, generally at about 37 weeks of pregnancy. If delivery cannot be delayed, the mother may be given a steroid hormone, similar to a natural substance produced in the body, which crosses the barrier of the placenta and helps the fetal lungs to produce surfactant. The steroid should be given at least 24 hours before the expected time of delivery. If the infant does develop RDS, the risk of bleeding into the brain will be much less if the mother has been given a dose of steroid.

If a very premature infant is born without symptoms of RDS, it may be wise to deliver surfactant to its lungs. This may prevent RDS or make it less severe if it does develop. An alternative is to wait until the first symptoms of RDS appear and then immediately give surfactant. Pneumothorax may be prevented by frequently checking the blood oxygen content and limiting oxygen treatment under pressure to the minimum needed.

Parental concerns

Parents should monitor their newborn infant's breathing status closely for the first week of life. Premature infants are of particular concern, although many may be hospitalized through the neonatal period. While a newborn is hospitalized, parents should try to maintain as much physical contact with the infant as is allowed by the hospital, and let the infant frequently hear the familiar voices of the parents, especially the mother, when physical contact is not recommended.

BOOKS

Beamis, John F., et al. Interventional Pulmonary Medicine. New York: Marcel Dekker, 2003.

Frankel, Larry R. "Respiratory Distress and Failure." In Nelson Textbook of Pediatrics, 17th ed. Edited by Richard E. Behrman et al. Philadelphia: Saunders, 2003, pp. 301–2.

Hanley, Michael E., and Carolyn H. Welsh. Current Diagnosis & Treatment in Pulmonary Medicine. New York: McGraw-Hill, 2003.

PERIODICALS

Bandi, V. D., et al. "Acute lung injury and acute respiratory distress syndrome in pregnancy." Critical Care Clinics 20, no. 4 (2004): 577–607.

Dicker, R. A., et al. "Acute respiratory distress syndrome criteria in trauma patients: why the definitions do not work." Journal of Trauma 57, no. 3 (2004): 522–6.

Louis, J. M., et al. "Perinatal intervention and neonatal outcomes near the limit of viability." American Journal of Obstetrics and Gynecology 191, no. 4 (2004): 1398–402.

Verger, J. T., et al. "The pragmatics of feeding the pediatric patient with acute respiratory distress syndrome." Critical Care Nursing Clinics of North America 16, no. 3 (2004): 431–43.

ORGANIZATIONS

American Academy of Emergency Medicine. 611 East Wells St., Milwaukee, WI 53202. Web site: <www.aaem.org/>.

American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211–2672. Web site: <www.aafp.org/>.

American Academy of Pediatrics. 141 Northwest Point Boulevard, Elk Grove Village, IL 60007–1098. Web site: <www.aap.org/default.htm>.

American College of Emergency Physicians. PO Box 619911, Dallas, TX 75261–9911. Web site: <www.acep.org/>.

American Lung Association. 1740 Broadway, New York, NY 10019. Web site: <www.lungusa.org/diseases/lungtb.html>.

American Thoracic Society. 1740 Broadway, New York, NY 10019. Web site: <www.thoracic.org/>.

Canadian Cystic Fibrosis Foundation. 2221 Yonge St., Suite 601, Toronto, Ontario, M4S 2B4, Canada. Web site: <www.ccff.ca/home.cfm>.

Cystic Fibrosis Foundation. 6931 Arlington Road, Bethesda, MD 0814. Web site: <www.cff.org/>.

WEB SITES

"Infant Respiratory Distress Syndrome." Penn State Children's Hospital. Available online at <www.hmc.psu.edu/childrens/healthinfo/r/respiratorydistress.htm> (accessed December 23, 2004).

"Respiratory distress syndrome (RDS) in infants." National Library of Medicine. Available online at <www.nlm.nih.gov/medlineplus/ency/article/001563.htm> (accessed December 23, 2004).

Rothenhaus, Todd. "Acute Respiratory Distress Syndrome." eMedicine, May 16, 2003. Available online at <www.emedicine.com/EMERG/topic15.htm> (accessed December 23, 2004).

Udobi, Kahdi, and Ed Childs. "Acute Respiratory Distress Syndrome." American College of Family Physicians. Available online at <www.aafp.org/afp/20030115/315.html> (accessed December 23, 2004).

L. Fleming Fallon, Jr., MD, DrPH