Respiratory Distress Syndrome ( Hyaline Membrane Disease )

DEFINITION

Respiratory distress syndrome (formerly also known as hyaline membrane disease) is a condition in which the air sacs (alveoli) in the lungs of the baby can not stay open due to the high surface tension due to the lack or absence of surfactant.

CAUSE

Surfactant is a substance that coats the alveoli in the lungs, which is produced by cells in the alveoli. The surfactant serves to keep the alveoli can remain open throughout the respiratory cycle so the baby can breathe freely. Surfactants are usually generated when started around 32 weeks gestation.

The more premature the baby is born, the less surfactant is present, so the greater the risk of respiratory distress syndrome in infants after birth.

Respiratory distress syndrome is almost always occurs in premature newborns, and is more common in babies born to mothers with diabetes. In rare cases, the syndrome is passed down in families.

In the majority of extremely premature infants, the lungs can be very stiff, so that the baby is not able to begin breathing at birth. However, more often, newborns tried to breathe, but because the lung is very stiff it happens great difficulty breathing.

SYMPTOMS

The symptoms of respiratory distress syndrome in newborns such as:

- Rapid breathing

- Attraction of the chest wall muscles while inhaling

- Nostril expands when breathing

- Shortness of breath and can occur stopping breathing (apnea)

- The color of the skin and mucous membranes turn blue due to low oxygen levels in the blood

For a few hours later, trouble breathing in infants tend to be more severe because of the fatigue of the muscles used for breathing effort, a bit of surfactant in the lungs has been used, and a growing number of alveolar collapse. In the end, if left untreated, newborns may experience damage to the brain and other organs of the body due to lack of oxygen or even death.

DIAGNOSIS

Diagnosis:

- The symptoms are there

- The results of a physical examination

- The results of blood gas analysis

- Abnormal chest radiograph

TREATMENT

After birth, the newborn with mild respiratory distress syndrome might only require supplemental oxygen administration. However, newborns syndrome, respiratory distress severe may require breathing aids, such as CPAP (Continuous Positive Airway Pressure), in which the baby can breathe by themselves when given oxygen or air is a little pressure on the nose, or it could be assisted with a ventilator ,

Surfactant administration may be actions that save lives and reduce complications such as pneumothorax. Artificial surfactant is given to work in the same way as the original surfactant.

PREVENTION

The risk of respiratory distress syndrome in newborns can be extremely lowered if the delivery was delayed until fetal lung surfactant has produced in sufficient quantities. If preterm labor can not be avoided, then the baby while still in the womb, can test lung maturity.

REFERENCE

- K, Arthur E. Respiratory Distress Syndrome. Merck Manual Handbook. 2009.

- K, Anand D. M, John T. Respiratory Distress Syndrome. The Merck Manual. 2012.