respiratory distress syndrome of the newborn

respiratory

[res´pir-ah-tor″e] pertaining to respiration.acute respiratory distress syndrome (adult respiratory distress syndrome) a group of symptoms accompanying fulminant pulmonary edema and resulting in acute respiratory failure; see also acute respiratory distress syndrome.respiratory care 1. the health care profession providing, under qualified supervision, diagnostic evaluation, therapy, monitoring, and rehabilitation of patients with cardiopulmonary disorders; it also employs educational activities to support patients and their families and to promote cardiovascular health among the general public.2. the care provided by members of this profession.3. the diagnostic and therapeutic use of medical gases and their administering apparatus, environmental control systems, humidification, aerosols, medications, ventilatory support, bronchopulmonary drainage, pulmonary rehabilitation, cardiopulmonary resuscitation, and airway management.respiratory distress syndrome, neonatal (respiratory distress syndrome of the newborn (RDS)) a condition of the newborn marked by dyspnea with cyanosis, heralded by such prodromal signs as dilatation of the nares, grunting on exhalation, and retraction of the suprasternal notch or costal margins. It usually occurs in newborns who are preterm, have diabetic mothers, or were delivered by cesarean section; sometimes there is no apparent predisposing cause.

This is the major cause of death in neonates and survivors have a high risk for chronic neurologic complications. No one factor is known to cause the condition; however, prematurity and interrupted development of the surfactant" >surfactant system is thought to be the major causative factor. Surfactant is secreted by the epithelial cells of the alveoli. It acts as a detergent, decreasing the surface tension of fluids that line the alveoli and bronchioles and allowing for uniform expansion of the lung and maintenance of lung expansion. When there is an inadequate amount of surfactant, a great deal of effort is required to re-expand the alveoli with air; thus the newborn must struggle for each breath. Insufficient expansion of the alveoli results in partial or complete collapse of the lung (atelectasis). This in turn produces hypoxemia and elevated serum carbon dioxide levels.
The hypoxemia causes metabolic acidosis from increased production of lactic acid and respiratory acidosis due to the hypercapnia. The lowered pH constricts pulmonary blood vessels and inhibits intake of oxygen, thus producing more hypoxemia and interfering with the transport of substances necessary for the production of the sorely needed surfactant.Patient Care. In order to minimize the hazards of oxygen toxicity and retinopathy of prematurity" >retinopathy of prematurity, the blood gases of the newborn with respiratory distress syndrome must be carefully monitored to assess response to therapy. The goal is to administer only as much oxygen as is necessary to maintain an optimal level of oxygenation.

To improve respiratory function, intubation, suctioning of the air passages, and pressure" >continuous positive airway pressure via nasal prongs are commonly used, as well as instillation of artificial surfactant. Monitoring is conducted using monitoring" >transcutaneous oxygen monitoring or a pulse oximeter. To optimize breathing effort and facilitate air exchange, the newborn is positioned on the back with a shoulder support to keep the neck slightly extended, or on the side with the head supported. Because of the drying effect of oxygen therapy and the prohibition of oral fluids, mouth care must be given frequently to prevent drying and cracking of the lips and oral mucosa.respiratory failure a life-threatening condition in which respiratory function is inadequate to maintain the body's need for oxygen supply and carbon dioxide removal while at rest; it usually occurs when a patient with chronic airflow limitation develops an infection or otherwise suffers an additional strain on already seriously impaired respiratory functions. Inadequate or unsuccessful treatment of respiratory insufficiency from a variety of causes can lead to respiratory failure. Called also ventilatory failure.

Early symptoms include dyspnea, wheezing, and apprehension; cyanosis is rarely present. As the condition worsens the patient becomes drowsy and mentally confused and may slip into a coma. blood gas analysis is an important tool in diagnosing respiratory failure and assessing effectiveness of treatment. The condition is a medical emergency that can rapidly progress to irreversible cardiopulmonary failure and death. Treatment is concerned with improving ventilation and oxygenation of tissues, restoring and maintaining fluid balance and acid-base balance, and stabilizing cardiac function.respiratory insufficiency a condition in which respiratory function is inadequate to meet the body's needs when increased physical activity places extra demands on it. Insufficiency occurs as a result of progressive degenerative changes in the alveolar structure and the capillary tissues in the pulmonary bed, as, for example, in chronic airflow limitation and fibrosis" >pulmonary fibrosis. Treatment is essentially supportive and symptomatic. If the condition is not successfully managed it may progress to respiratory failure.respiratory therapist a health care professional skilled in the treatment and management of patients with respiratory problems, who administers respiratory care. The minimum educational requirement is an associate degree, providing knowledge of anatomy, physiology, pharmacology, and medicine sufficient to serve as a supervisor and consultant. Those registered by the National Board for Respiratory Therapy are designated Registered Respiratory Therapist (RRT).respiratory therapy respiratory care.respiratory therapy technician a health care professional who has completed a specialized one- or two-year educational program and who performs routine care, management, and treatment of patients with respiratory problems under the supervision of a respiratory therapist. Such programs are usually found in community colleges and are accredited by the Joint Review Committee for Respiratory Therapy Education.

hy·a·line mem·brane dis·ease of the new·born

a disease seen especially in premature neonates with respiratory distress; characterized postmortem by atelectasis and alveolar ducts lined by an eosinophilic membrane; also associated with reduced amounts of lung surfactant. Synonym(s): hyaline membrane syndrome, respiratory distress syndrome of the newborn