Neonatal respiratory distress syndrome

Alternative Names

Symptoms

The symptoms usually appear within minutes of birth, although they may not be seen for several hours. Symptoms may include:

• Bluish color of the skin and mucus membranes (cyanosis)
• Brief stop in breathing (apnea)
• Decreased urine output
• Grunting
• Nasal flaring
• Puffy or swollen arms or legs
• Rapid breathing
• Shallow breathing
• Shortness of breath and grunting sounds while breathing
• Unusual breathing movement -- drawing back of the chest muscles with breathing

Exams and Tests

A blood gas analysis shows low oxygen and excess acid in the body fluids.

A chest x-ray shows respiratory distress. The lungs have a characteristic "ground glass" appearance, which often develops 6 to 12 hours after birth. Lung function studies may be needed.

Lab tests are done to rule out infection and sepsis as a cause of the respiratory distress.

References

Cloherty J, Stark A, Eichenwald E. Manual of Neonatal Care. 5th ed. Lippincott, Wilkins and Williams; 2003.

Cole FS. Defects in surfactant synthesis: clinical implications. Pediatr Clin North Am. Oct 2006; 53(5): 911-27.

Courtney SE. Continuous positive airway pressure and noninvasive ventilation. Clin Perinatol. Mar 2007; 34(1): 73-92.

Kinsella JP, Inhaled nitric oxide in the premature newborn. J Pediatr. Jul 2007; 151(1): 10-5.

Lampland AL. The role of high-frequency ventilation in neonates: evidence-based recommendations. Clin Perinatol. Mar 2007; 34(1): 129-44.

Stevens TP. Surfactant replacement therapy. Chest. May 2007; 131(5): 1577-82.