How Is Respiratory Distress Syndrome Treated?

Treatment for respiratory distress syndrome (RDS) usually begins as soon as an infant is born, sometimes in the delivery room.

Most infants who show signs of RDS are quickly moved to a neonatal intensive care unit (NICU). There they receive around-the-clock treatment from health care professionals who specialize in treating premature infants.

The most important treatments for RDS are:

• Surfactant replacement therapy.
• Breathing support from a ventilator or nasal continuous positive airway pressure (NCPAP). These machines help premature infants breathe better.
• Oxygen therapy.

Surfactant Replacement Therapy

Surfactant is a liquid that coats the inside of the lungs. It helps keep them open so that an infant can breathe in air once he or she is born.

Infants who have RDS are given surfactant until their lungs have developed enough to start making their own surfactant. Surfactant usually is given through a breathing tube that's attached to a bag to help push the surfactant directly into the baby's lungs.

Once the surfactant is given, the breathing tube is connected to a ventilator, or the baby may get breathing support from NCPAP.

Surfactant often is given right after birth in the delivery room to try to prevent or treat RDS. It may be given several times over the next few days, until the baby is able to breathe better.

Some women are given medicines called corticosteroids during pregnancy. These medicines can speed up surfactant production and lung development in a fetus. Even if you had these medicines, your infant may still need surfactant replacement therapy after birth.

Breathing Support

Infants who have RDS often need breathing support until their lungs start making enough surfactant. Until recently, a mechanical ventilator usually was used. The ventilator was connected to a breathing tube that ran through the infant's mouth or nose into the windpipe.

Today, more and more infants are receiving breathing support from an NCPAP machine. NCPAP gently pushes air into the baby's lungs through prongs placed in the infant's nostrils.

Oxygen Therapy

Infants who have breathing problems may get oxygen therapy. Oxygen may be given through the ventilator or NCPAP machine, or through a tube in the nose. Oxygen therapy is given to make sure that the infants' brains, hearts, livers, and kidneys get enough oxygen to work properly.

Other Treatments

Other treatments for RDS include medicines, supportive therapy, and treatment for patent ductus arteriosus (PDA). PDA is a condition that affects some premature infants.

Medicines

Doctors often give antibiotics to infants who have RDS to control infections (if the doctors suspect that an infant has an infection).

Supportive Therapy

Treatment in the NICU is designed to limit stress on babies and meet their basic needs of warmth, nutrition, and protection. Such treatment usually includes:

• Using a radiant warmer or incubator to keep infants warm and reduce the chances of infection.
• Ongoing monitoring of blood pressure, heart rate, breathing, and temperature through sensors taped to the babies' bodies.
• Using sensors on fingers or toes to check the amount of oxygen in the infants' blood.
• Giving fluids and nutrients through needles or tubes inserted into the infants' veins. This helps prevent malnutrition and promotes growth. Nutrition is critical to the growth and development of the lungs. Later, babies may be given breast milk or infant formula through feeding tubes that are passed through their noses or mouths and into their throats.
• Checking fluid intake to make sure that fluid doesn't build up in the babies' lungs.

Treatment for Patent Ductus Arteriosus

PDA is a possible complication of RDS. In this condition, a fetal blood vessel called the ductus arteriosus doesn't close after birth as it should.

The ductus arteriosus connects a lung artery to a heart artery. If it remains open, it can put strain on the heart and increase blood pressure in the lung arteries.

PDA is treated with medicines, catheter procedures, and surgery. For more information, go to “How Is Patent Ductus Arteriosus Treated?”