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Chapter-15 Respiratory Distress syndrome

BOOK TITLE: Recent Advances in Pediatrics (Volume 20: Hot Topics)

Author
1. Kumar Ashok
2. Basu Sriparna
ISBN
9789350252475
DOI
10.5005/jp/books/11254_15
Edition
1/e
Publishing Year
2011
Pages
18
Author Affiliations
1. All India Institute of Medical Sciences, New Delhi, India, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India, Institute of Medical Sciences, Banaras Hindu University (BHU), Varanasi, UP, India, University of Rajasthan, Jaipur, Rajasthan, India, Fortis Flt Lt Rajan Dhall Hospital Vasant Kunj, New Delhi, India, Maulana Azad Medical College and LN Hospital, New Delhi, Sanjay Gandhi PGI, Lucknow, Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow, India, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India, Maulana Azad Medical College, New Delhi, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, Central Bureau of Health Intelligence, Dte. General of Health Services, Nirman Bhawan, New Delhi, Maulana Azad Medical College and Loknayak Hospital, New Delhi, India, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, Fortis Flt. Lt. Rajan Dhall Hospital, Vasant Kunj, New Delhi, India, Dubai Bone and Joint (DBAJ) Center, Mohammed Bin Rashid Al Maktoum Academic Medical Center, (BBRM-AMC), Dubai Healthcare City (DHCC), Dubai, UAE; Exeter Hip Center, UK, Trauma and Orthopedics Katharinen Hospital, Germany, PGIMER, Chandigarh, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, Uttar Pradesh, India, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India, Maulana Azad Medical College and Lok Nayak Jai Prakash Narayan Hospital, New Delhi, India, Maulana Azad Medical College, New Delhi, India
2. Institute of Medical Sciences, Banaras Hindu University (BHU), Varanasi, UP, India, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India, Neonatology Unit; Institute of Medical Sciences, Banaras Hindu University (BHU), Varanasi, Uttar Pradesh, India, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
Chapter keywords

Abstract

Respiratory distress syndrome (RDS) is a disease of prematurity and caused by the deficiency of surfactant. Single course of antenatal betamethasone or dexamethasone should be given to mothers between 24 to 35 weeks’ gestation if delivery is imminent within next 7 days. Neonate should be resuscitated gently, avoiding excessive tidal volumes and exposure 100% oxygen, using pulse oximetry as a guide provided there is an adequate heart rate response. For extremely preterm infants, consider intubation in delivery suite for prophylactic surfactant administration. For more mature babies, CPAP should be initiated early. Natural surfactants should be used and given as early as possible in the course of RDS. Repeat doses of surfactant may be required if there is ongoing evidence of RDS. Babies should be maintained on CPAP in preference to ventilation if possible. More mature babies can often be extubated to CPAP immediately following surfactant, and a judgement needs to be made if an individual baby will tolerate this. For those who require mechanical ventilation, aim to ventilate for as short a time as possible, avoiding hyperoxia, hypocapnia and volutrauma. Caffeine therapy should be used to minimize need for and duration of ventilation. Maintain body temperature in the normal range. Careful fluid balance is required with early aggressive nutritional support using parenteral nutrition whilst enteral feeding is being established.

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