Journal of Neonatal Biology

Respiratory Distress Syndrome in Preterm Newborn Infants

David Milligan^* Department of Neonatology, University of Missouri School of Medicine, Kansas, USA
^*Correspondence: David Milligan, Department of Neonatology, University of Missouri School of Medicine, Kansas, USA, Email:

Received: 23-Sep-2022, Manuscript No. JNB-22-18711; Editor assigned: 27-Sep-2022, Pre QC No. JNB-22-18711 (PQ); Reviewed: 13-Oct-2022, QC No. JNB-22-18711; Revised: 18-Oct-2022, Manuscript No. JNB-22-18711 (R); Published: 27-Oct-2022, DOI: 10.35248/2167-0897.22.11.373

Description

RDS, also known as neonatal respiratory distress syndrome, is a frequent cause of respiratory distress in newborns. It usually manifests within hours after birth, most frequently right after delivery. Term newborns are rarely affected with RDS and are typically preterm neonates. With more severe disease in the smaller and more preterm neonates, the incidence of RDS is inversely proportional to the gestational age of the newborn. RDS remains to be the leading cause of morbidity and mortality in preterm infants, despite the fact that treatment options such prenatal corticosteroids, surfactants, and sophisticated respiratory care of the newborn have improved patient outcomes.

The most common reason for neonatal morbidity in premature newborns is Respiratory Distress Syndrome (RDS), which is brought on by lung immaturity and a lack of surfactants. RDS continues to be the primary justification for invasive ventilation in newborns, despite a growing desire to adopt non-invasive ventilator assistance. Although mechanical ventilation can sometimes save lives, it carries the danger of causing more lung damage and contributes to the development of Bronchopulmonary Dysplasia (BPD) in infants who were born significantly preterm.

Utilizing small tidal volumes, making sure there is a sufficient degree of Positive End-Expiratory Pressure (PEEP), and timing the support with the patient's spontaneous breathing can all help to lower the risk of ventilator-induced lung injury. Optimizing ventilation in a neonatal population is difficult due to small tidal volumes, high breathing frequency, and the use of unstuffed intubation tubes that cause an air leak from the circuit. Pneumatic triggers are therefore not ideal for this particular patient population. The Neural Adjusted Ventilator Assist (NAVA) allows for physiological changes in tidal volume and inspiratory duration while providing ventilator support proportionate to the patient's diaphragm's electrical activity. NAVA has been demonstrated to improve patient-ventilator synchronization and decrease labour of breathing in newborns, leading to reduced Peak Inspiratory Pressures (PIP) and oxygen requirements compared to conventional ventilation. Although NAVA is being utilized more frequently in neonatal intensive care units, there is a lack of information on how it affects clinical outcomes in the preterm population.

Surfactant deficit is what leads to neonatal respiratory distress syndrome, especially when the lungs are still developing. The small airways and alveoli's surface tension rises due to a surfactant shortage, which lowers the young lung's compliance. To avoid the alveolus collapsing or filling with fluid, a delicate balance of pressures at the air-fluid interface is necessary.

Due to an eosinophilic membrane that borders the distal airspaces in autopsies of newborns with RDS, which are typically terminal bronchioles or alveolar ducts, neonatal respiratory distress syndrome was once known as hyaline membrane disease. Lung tissue from infants with RDS has a macroscopic appearance similar to reddish hepatic tissue. Red blood cells, leukocytes, fibrin, and lung epithelial debris make up the hyaline membrane indicated above. A widespread area of atelectasis may be accompanied by lung tissue that has few dilated alveoli, according to a microscopic histological study. RDS infants require more oxygen. There are numerous ways to administer it, including using a nasal cannula, a tiny tube with prongs inserted into the nostrils. A CPAP machine uses gentle air or oxygen pressure to keep the air sacs in the lungs open while sleep. A ventilator is a device that assists a baby in breathing when they are unable to do it on their own. The infant's windpipe is threaded with a breathing tube. It is known as intubation. The baby is subsequently put on the ventilator to assist with breathing.

To make up for what the baby's lungs lack, surfactant might be administered. This is administered directly through the windpipe-inserted breathing tube. A catheter, a very tiny tube, is inserted into one or more of the umbilical cord's blood vessels. The infant receives feeding, fluids, and medications in this manner. Blood samples are also drawn using this method. When an infection is detected, antibiotics are occasionally administered. To help reduce pain during therapy, calming medications may be administered.