Neonatal respiratory distress syndrome medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Medical Therapy

Oxygen is given with a small amount of continuous positive airway pressure ("CPAP"), and intravenous fluids are administered to stabilize the blood sugar, blood salts, and blood pressure. If the baby's condition worsens, an endotracheal tube (breathing tube) is inserted into the trachea and intermittent breaths are given by a mechanical device. An exogenous preparation of surfactant, either synthetic or extracted from animal lungs, is given through the breathing tube into the lungs. One of the most commonly used surfactants is Survanta, derived from cow lungs, which can decrease the risk of death in hospitalized very-low-birth-weight infants by 30%[1]. Such small premature infants may remain ventilated for months. Chronic lung disease including bronchopulmonary dysplasia are common in severe RDS. The etiology of BPD is problematic and may be due to oxygen, overventilation or underventilation. The mortality rate for babies greater than 27 weeks gestation is less than 10%.

References

  1. Schwartz, R.M., Luby, A.M., Scanlon, J.W., & Kellogg, R.J. Effect of surfactant on morbidity, mortality, and resource use in newborn infants weighing 500 to 1500 g. New England Journal of Medicine, 330 (1994): 1476-1480.

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