Respiratory Distress Syndrome (Pediatric)

What is respiratory distress syndrome (RDS)?

This is the most common breathing problem in premature infants. The earlier the delivery, the greater the risk of RDS. This condition is caused by an insufficient amount of surfactant, a foamy, fluid substance produced by the lungs between the 34th and 36th week of pregnancy. Surfactant lubricates the air sacs in the lungs (alveoli) and allowing them expand without over-stretching and to get smaller without collapsing. This rhythm of expansion and contraction is what moves the air into and out of the lungs.
RDS can range from mild to severe.

What are the signs of RDS?

Symptoms may include:

  • Cyanosis (a bluish color of the skin)
  • Brief stops in breathing
  • Flaring nostrils
  • Rapid breathing
  • Shallow breathing
  • Shortness of breath or grunting sounds
  • Abnormal movements while breathing

How is RDS diagnosed?

Several tests are needed to rule out other conditions that result in breathing problems. The tests include:

  • Chest X-ray shows the structures of the heart and lungs and can help determine whether your child has RDS. It also can detect other problems, such as a collapsed lung, that may require urgent treatment.
  • Blood tests show if there's enough oxygen in an infant's blood. They can also determine if an infection is the root cause of a baby's breathing problems.
  • Echocardiography uses sound waves to take a moving picture of the heart and find out if a defect in this organ is the cause of an infant's breathing problems.

How is RDS treated?

Mild cases often respond to breathing support with nasal Continuous Positive Airway Pressure (nasal-CPAP). Some extra oxygen may be added as well.

In more severe cases, infants may need a breathing tube and for a time, some may be connected to a breathing machine.

An artificial surfactant can also be placed in the baby’s lungs through the breathing tube. This helps the lungs expand and move the air with greater ease. RDS usually starts to improve by the third or fourth day of life.