Science Letters

Recent understanding of Pathophysiology, Risk factors and treatments of Neonatal Respiratory Distress Syndrome: A review

Monica, Furqan Nasir, Sinarinzi Pamela, Qian Li Juan, Jiang Li*

Department of Pediatrics and NICU, Zhongda affiliated Hospital, Southeast University, 210009, Nanjing, China

Abstract

Neonatal respiratory distress syndrome (NRDS), most regularly seen in preterm babies, is induced by the shortage of surfactant in the lungs. Clinical manifestations of RDS are grunting, tachypnea, retractions, nasal flaring and necessity for complementary oxygen. In the previous three eras, the consequences of RDS have greatly improved by the initiation of antenatal steroids and exogenous surfactant; nevertheless, it still persists as a predominant trouble. In china, respiratory distress typically for late preterm or term newborns is still an ultimate reason for Neonatal Intensive Care Unit (NICU) admissions. Recently found that a growing trend of frequency of NRDS is seen in late preterm infants, which is almost a third of babies with NRDS. The pathophysiological basis of NRDS is surfactant deficit, which is closely related to the gestational age or birth weight. Risk of RDS increases with prematurity. By chest radiography results and acidosis, the diagnosis can be evaluated. Over the past years, mortality from respiratory distress syndrome has fallen significantly due to advances in NICU and better practice of antenatal steroids and surfactant administration. More current clinical trials illustrate that intubation can be avoided either by an initial introduction of continuous positive airway pressure (CPAP) in the labor room to stabilize premature babies and administer selective intratracheal surfactant. This review gives emphasis to the pathophysiology of RDS, risk factors and some of the recent up-to-date approaches for the treatment of RDS in preterm neonates.