What's the treatment for infant respiratory distress syndrome?
High-risk and premature infants require prompt attention by a pediatric resuscitation team. First, the infant is given high oxygen and humidity concentrations. Infants with mild symptoms are given supplemental oxygen. It is important to guard against too much oxygen, as this may damage the retina and cause loss of vision. Using an oximeter to keep track of the
blood oxygen level, repeated artery punctures or heel sticks can be avoided.
Those with severe symptoms are managed on a ventilator to deliver both oxygen and pressure to keep the lungs inflated. In tiny infants who do not breathe when born, ventilation through a tracheal tube is an emergency procedure. Assisted ventilation must be closely supervised, as too much pressure can cause further lung damage. A gentler way of assisting breathing, continuous positive airway pressure or CPAP, delivers an oxygen mixture through nasal prongs or a tube placed through the nose rather than an endotracheal tube. CPAP may be tried before resorting to a ventilator, or after an infant placed on a ventilator begins to improve. Drugs that stimulate breathing may speed the recovery process.
An artificial lung surfactant is sometimes delivered through an endotracheal tube into the lungs of an infant at high risk for respiratory distress syndrome immediately after birth. Studies find that this treatment can prevent or improve the course of respiratory distress syndrome. Enough research has been done on surfactants to show that they reduce death from IRDS. Typically the infant will be able to breathe more easily within a few days at the most, and complications such as lung rupture are less likely to occur. The drug is continued until the infant starts producing its own surfactant. There is a risk of bleeding into the lungs from surfactant treatment; about 10% of the smallest infants are affected. |
