Respiratory distress syndrome infants

Respiratory distress syndrome infants.  Photo from www.curoservice.com

Breath — the basis of our life. Newborn human life begins with the first breath, but breathing problems can lead to serious complications, sometimes incompatible with life.

Respiratory distress syndrome (RDS)— One of the major problems to be faced doctors, nurse premature babies. RDS — a disease of newborn infants, the development of respiratory insufficiency manifesting itself or within a few hours after birth. The disease gradually becomes heavier. Usually, to2-4 day of life is determined by its outcome: the gradual recovery or death of the baby.

Why is the baby's lungs refuse to carry out its functions? Let us try to look into the depths of this vital organ and understand — that's what.

Surfactant

Our lungs are made up of numerous small sacs — alveoli. The total surface area is comparable to their football field. One can imagine how tightly packed in all the thorax. But to the alveoli perform its primary function — gas exchange — they should be flat. Spadenie prevents the alveoli special "grease" — Surfactant. The name comes from a unique material angiysky words surface— Surface andactive— Active, that is, surfactant. It reduces the surface tension of the inner facing the air, the alveolar surface, do not let them be fallen down during exhalation.

Surfactant — a unique complex of proteins, carbohydrates, and phospholipids. The synthesis of this material is the epithelial cells lining the alveoli — alveolocytes. In addition, this "grease" has a number of remarkable properties — it is involved in the exchange of gases and liquids through the pulmonary barrier to remove foreign particles from the surface of the alveoli, alveolar walls protection from oxidants and peroxide, to some degree — and from mechanical damage.

While the fetus is in the womb, his lungs are not functioning, but, nevertheless, they are quietly preparing for the future spontaneous breathing — to23 minutes week of development alveolocytes begin to synthesize surfactant. The optimal amount thereof — about 50 cubic millimeters per square meter of surface light — accumulates only36th week. However not all babies "was serving" before that date, and for various reasons appear to white light before laid 38-42 weeks. And this is where the problems begin.

What's going on?

Insufficient amount of surfactant in the lungs of premature infants leads to the fact that as you exhale the lungs as it slammed shut (falling), and the child has with each breath they re-inflate. It requires a lot of energy, as a result of force newborn depleted and develop severe respiratory failure. In 1959, American scientists ME Avery and J. Mead was detected failure of pulmonary surfactant in preterm infants with respiratory Distress Syndrome and thus established the fundamental cause of RDS. The incidence of RDS is higher, the smaller the period, which was born baby. So, they suffer from an average of 60 percent of babies born at term gestation less than 28 weeks, 15-20 percent — in the period 32-36 weeks, and only 5 percent — at the term of 37 weeks or more.

The clinical picture of the syndrome manifested primarily symptoms of respiratory distress, developing, usually at birth, or through 2-8 hours after birth — shortness of breath, swelling of the nose wings, retraction of intercostal spaces, participation in the act of breathing auxiliary respiratory muscles, development cyanosis (cyanosis). Because of inadequate ventilation often joins a secondary infection and pneumonia in these infants — is not uncommon. The natural healing process begins after 48-72 hours of life, but not all children, this process is fast enough — because of development of infectious complications already mentioned.

Mother care for rational and careful observance of protocols for infants with RDS survive up to 90 percent of young patients. Transferred respiratory distress syndrome in the future practically no effect on the health of children.

Risk Factors

It is difficult to predict, will develop in the individual child RDS or not, however, scientists have been able to carve out a risk. Predispose to the development of the syndrome, diabetes, infection, and maternal smoking during pregnancy, mother, delivery by caesarean section, the birth of the second of twins, birth asphyxia. Also found that boys are affected more often RDS girls. Prevention of RDS is reduced to the prevention of preterm birth.

Treatment

Diagnosis of respiratory Distress Syndrome conducted in a hospital.

Mainstay of treatment for infants with RDS technology is "minimal touch" baby should receive only the absolutely necessary for him and manipulation procedures. One of the treatments for the syndrome — an intensive respiratory therapy, various types of mechanical ventilation (mechanical ventilation).

It would be logical to assume that once RDS is caused by deficiencies of surfactant, and then treat the syndrome to the introduction of this substance from the outside. However this involves so many restrictions and complexities that the active use of preparations of artificial surfactant started only at the end 80th— Early 90th the last century. Surfaktantoterapiya allows much easier to improve the child's condition. However these drugs are very expensive, high efficiency of their application only if they are used in the first few hours after birth, and to use them, you must have modern equipment and qualified medical personnel, since there is a high risk of severe complications.

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