Respiratory distress syndrome in the newborn
The most common cause of surfactant deficiency is premature birth. Less commonly, genetic mutations in surfactant protein (SP) B, SP-C, and adenosine triphosphate (ATP)-binding cassette (ABC) transporter can decrease surfactant production. These mutations can cause RDS in full-term infants. Partial mutations in surfactant proteins can lead to interstitial lung disease in children.
Symptoms of RDS occur within several minutes to hours after birth. Symptoms include cyanosis, tachypnea, nasal flaring, grunting, and accessory muscle use. RDS typically progresses for 48-72 hours and resolves in 1 week.
Treatment is with exogenous surfactant and supportive care. Complications of RDS include pulmonary air leak due to ruptured alveoli, which can cause pneumomediastinum or pneumothorax and bronchopulmonary dysplasia (BPD).
Related topic: acute respiratory distress syndrome
P22.0 – Respiratory distress syndrome of newborn
46775006 – Respiratory distress syndrome in the newborn
Differential Diagnosis & Pitfalls
- Hemolytic disease of the newborn
- Acute respiratory distress syndrome
- Transient tachypnea of the newborn
- Interstitial lung disease
- Pulmonary interstitial glycogenosis
- Meconium aspiration
- Cyanotic congenital heart disease
- Persistent pulmonary hypertension
- Bronchopulmonary dysplasia
- Cystic adenomatoid malformation
- Metabolic acidosis