Neonatal respiratory distress syndrome

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Neonatal respiratory distress syndrome

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USMLE® Step 1 style questions USMLE

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A 1-day-old boy is brought to the intensive care unit from the nursery due to increased work of breathing. The patient was born at 31 weeks to a mother with a history of multiple preterm deliveries, polysubstance abuse and HIV. His temperature is 38°C (100.4°F), pulse is 215/min, respirations are 76/min, blood pressure is 60/41 mmHg, and oxygen saturation is 85% on room air. Physical exam shows tachypnea, nasal flaring, and subcostal retractions. Administration of supplemental oxygen and positive pressure ventilation improve the patient's oxygen saturation to 95%. Blood glucose is 95 mg/dL. Chest x-ray and laboratory results are shown below:  

 
Reproduced from: Wikipedia
 
Laboratory value  Result 
Blood Gases, Serum 
pH  7.23 
 PCO2  55 mmHg 
 PO2  30 mmHg 
Which of the following best describes the etiology of this infant’s disease process?

External References

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Bronchopulmonary dysplasia p. 211

neonatal respiratory distress syndrome as cause p. 679

C-section deliveries

neonatal respiratory distress syndrome p. 679

Diabetes mellitus p. 350-358

neonatal respiratory distress syndrome p. 679

Hyaline membrane disease p. 694

Intraventricular hemorrhage p. NaN

neonatal respiratory distress syndrome as cause p. 679

Metabolic acidosis p. 610

neonatal respiratory distress syndrome p. 679

Necrotizing enterocolitis p. 393

neonatal respiratory distress syndrome and p. 679

Neonatal respiratory distress syndrome (NRDS) p. 679

restrictive lung disease p. 694

Patent ductus arteriosus (PDA)

neonatal respiratory distress syndrome and p. 679

Premature labor and delivery

neonatal respiratory distress syndrome and p. 679

Summary

Infant respiratory distress syndrome (IRDS), also called neonatal respiratory distress syndrome, is a syndrome common in premature infants that is caused by developmental insufficiency of surfactant production and structural immaturity in the lungs. The result is inability to exchange oxygen and carbon dioxide effectively across the alveolar-capillary membrane.

Symptoms of RDS may include rapid breathing, grunting, flaring of the nostrils, and cyanosis (bluish skin and lips). The severity of the symptoms can vary depending on the severity of the RDS. Treatment for RDS may include supplemental oxygen, respiratory support, and medications to improve lung function.

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