RDS

Respiratory Distress Syndrome (RDS) occurs immediately after birth, the onset of symptoms usually occurs before 6 hours of age. Chest X-rays often reveal a diffuse granular opacification of the lung fields. Analysis of the blood gases often demonstrates hypoxemia and, in severe cases, acidosis and hypercapnia (see physiopathology).

Once the lungs are depleted of surfactant the alveoli collapse and the lungs become stiff. Lung compliance falls considerably, there is decreased functional residual capacity, increased dead space and work of breathing, severe hypoxemia and hypoventilation causing respiratory acidosis.

Histological changes show interstitial edema and congestion of the alveolar walls as well as exsudation into the alveoli (proteins in the exsudate coagulate to form hyaline membranes that line the alveoli).

Other clinical features may include hypotension and acidosis.
After an improvement following resuscitation and initial stabilization, the natural course of RDS is often characterized by a progressive worsening for 48 to 72 h before a gradual recovery.
Acute complications include air leaks and they are associated with intracranial hemorrhage.
Long term, RDS is associated with an increased incidence of Broncho Pulmonary Dyspasia (BPD) and neurologic impairment.