Infants with respiratory distress syndrome (RDS) have trouble breathing because the lungs don’t work properly. The alveoli, which are the tiny air sacs inside of the lungs, collapse, which makes it hard for the infant to breathe. Common in premature infants – those born six weeks or more before their due date – RDS is the result of a lack of surfactant, which is a naturally occurring substance that coats the lungs and is secreted by the alveoli. When there isn’t enough surfactant at birth, infants can experience respiratory distress because the alveoli cannot reopen after they collapse. This can result in the infant not having enough oxygen, thereby complicating organ functions. Surfactant is usually produced just a few weeks before birth, which is why respiratory distress is common in premature infants.
Sometimes a membrane, called a hyaline membrane, forms around the air sacs in the lungs. This makes it even more difficult for oxygen to reach the tiny blood vessels around the alveoli. That’s why infant RDS is sometimes called hyaline membrane disease.
An infant who experiences respiratory distress due to collapsed alveoli should be treated as soon as RDS is diagnosed. This typically will happen directly after birth. Infants with respiratory distress need specialized care in a neonatal intensive care unit (NICU). Babies in the NICU receive care from doctors and nurses who specialize in treating infant respiratory distress disorders, among others.
Once in the NICU, infants with respiratory distress need immediate help with their breathing and restoring proper alveoli function. This can be achieved through a variety of different treatments and therapies. For example, an infant with respiratory distress might receive pulmonary surfactant replacement therapy, which involves administering artificial surfactants. These are administered until the infant is able to produce surfactant on his or her own, and the lungs and alveoli become more developed.
Artificial pulmonary surfactants are typically administered through a tube that sends the medication directly into the infant’s lungs. Ideally, the infant will be able to breathe easier in days and weeks following surfactant therapy. Another treatment option is for infants with respiratory distress to receive breathing support from a mechanical ventilator or a nasal continuous positive airway pressure machine (NCPAP).
Surfactant therapy should only be administered by medical professionals within the confines of an NICU. Parents should talk with their child’s doctor about specific instructions after the baby is released from the NICU and has completed his or her respiratory distress treatment.