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Infant Acute Respiratory Distress Syndrome

Hyaline Membrane Disease


Presentation

  • Presentation Usually preterm delivery. Presents with respiratory distress very soon after birth: tachypnoea, expiratory grunting, subcostal and intercostal retractions, diminished breath sounds, cyanosis and nasal flaring.[patient.info]
  • Neonatal respiratory distress syndrome Prevalence: 1-5 / 10 000 Inheritance: Not applicable Age of onset: Infancy , Neonatal ICD-10: P22.0 OMIM: 267450 UMLS: C0020192 C0035220 C0852283 MeSH: - GARD: - MedDRA: - The documents contained in this web site are presented[orpha.net]
  • Chest X-ray revealed bilateral ground-glass opacities disclosing a presentation of acute respiratory distress syndrome. F ig . 2. Chest X-ray revealed bilateral ground-glass opacities disclosing a presentation of acute respiratory distress syndrome.[academic.oup.com]
  • Since surfactant normally develops late in prenatal life it usually is not present in the very premature infant of about 26-36 weeks of gestational age.[rarediseases.org]
Pneumonia
  • Surfactant inactivation--and dysfunction--is also a hallmark in newborns with meconium aspiration syndrome (MAS), pneumonia and other disorders affecting the pulmonary function.[ncbi.nlm.nih.gov]
  • In preterm infants with group B streptococcal (GBS) pneumonia, surfactant substitution resulted in an improvement in gas exchange.[nature.com]
  • Pulmonary infection - eg group B beta-haemolytic streptococcal pneumonia. Pulmonary haemorrhage. Meconium aspiration pneumonia. Oxygen toxicity along with pressure or volume trauma to the lungs.[patient.info]
  • To be defined as affected by ARDS, for example, the infant should be affected by acute respiratory failure within 7 days of the onset of a triggering factor, such as diffuse pneumonia.[researchitaly.it]
  • The causes of deaths were as follows; one of resistant disease, 4 of ARDS, one of interstitial pneumonia, and one of bacterial sepsis after receiving haploidentical stem cell transplant because of prolonged pancytopenia.[bloodjournal.org]
Tachypnea
  • The symptoms usually appear shortly after birth and may include tachypnea, tachycardia, chest wall retractions (recession), expiratory grunting, nasal flaring and cyanosis during breathing efforts.[orpha.net]
  • While each baby may experience symptoms differently, some of the most common symptoms of HMD include: difficulty breathing at birth that gets progressively worse cyanosis (blue coloring) flaring of the nostrils tachypnea (rapid breathing) grunting sounds[childrenshospital.org]
  • Presentation Symptoms dyspnea, tachypnea during first hours of life nasal flaring expiratory grunting, intercostal, subxiphoid retractions Physical exam severe hypoxemia not responsive to 100% O 2 atelectasis results in intrapulmonary (right-to-left)[medbullets.com]
  • Patients initially present with acute onset cyanosis, dyspnea, and tachypnea.[amboss.com]
Vaginal Bleeding
  • Betamethasone was not completed and the mother did not have vaginal bleeding. Apgar scores were 2 at 1 mn, 2 at 5 mn and 7 at 10 mn. The amniotic liquid was clear.[omicsonline.org]

Treatment

  • Clinical experience seems to justify surfactant treatment in neonates with ARDS.[ncbi.nlm.nih.gov]
  • Statistically there is a highly significant difference between Surfactant treatment group and not given surfactant treatment group (p 0.01).[jemds.com]
  • Abstract Surfactant treatment in preterm infants and term newborns with (acute respiratory distress syndrome) ARDS-like severe respiratory failure has become part of an individualized treatment strategy in many intensive care units around the world.[nature.com]
  • Evidence suggests early treatment within 2 hours of delivery is more beneficial than if treatment is delayed. They'll also be given fluids and nutrition through a tube connected to a vein.[nhs.uk]
  • […] a complication of the treatment is Figure C 5 The chest x-ray would reveal ground glass opacities and the fundoscopic image depicting a complication of the treatment is Figure B M1 Select Answer to see Preferred Response PREFERRED RESPONSE 5 (M1.PL.75[medbullets.com]

Prognosis

  • The prognosis is much better for babies weighing over 1500 g. Prevention Antenatal corticosteroids (dexamethasone) accelerate fetal surfactant production and lung maturation.[patient.info]
  • […] estimation for patients with ARDS Open lung biopsy provided a specific diagnosis for 84% of ARDS patients and an alternative treatment for 73% cases ( Ann Thorac Surg 2014;98:1254 ) ARDS with DAD has poorer prognosis ( see prognostic factors ) Carefully[pathologyoutlines.com]
  • Treatment and prognosis ARDS carries a high mortality of around 50% 2 and many survivors develop chronic lung disease, with damaged lung healing by fibrosis. A minority recover fully.[radiopaedia.org]

Etiology

  • Primary HLH appears to have a genetic etiology, whereas secondary HLH may occur together with a variety of underlying diseases [ 8 ].[academic.oup.com]
  • Etiology The causes of ARDS can result from direct lung injury, termed pulmonary ARDS, or extrapulmonary where the triggering insult is outside of the lungs. These two etiological subtypes respond in different ways to mechanical ventilation.[radiopaedia.org]
  • Laboratory tests and microbiological findings pointed to viral etiology of bronchiolitis (Influenza A and RSV ).[signavitae.com]
  • The etiology of BPD is problematic and may be the result of oxygen, overventilation or underventilation. The mortality rate for babies greater than 27 weeks of gestation is less than 20%.[en.wikipedia.org]
  • Etiology Systemic causes Sepsis (most common cause) Shock Massive transfusion (See “ TRALI ” for details) Acute Pancreatitis Hematopoietic stem cell transplantation Medication (e.g., salicylic acid, tricyclic antidepressants, bleomycin ) Recreational[amboss.com]

Epidemiology

  • […] the result of a scientific and technical-logistical effort that lasted over two years”, explained Giorgio Conti, “which included repeated meetings and which, at the same time, extended the project to a second phase aimed at describing clinical course, epidemiology[researchitaly.it]
  • Epidemiology The incidence and severity are related inversely to the gestational age of the infant. It affects approximately one half of infants born at 28-32 weeks of gestation. It may (rarely) occur at term.[patient.info]
  • Epidemiological history was positive for upper respiratory tract infection. Personal history revealed that she had been prenatally diagnosed with omphalocele.[signavitae.com]
  • A standard definition would allow comparisons to the adult and pediatric literature, as well as furthering research on the pathophysiology, epidemiology and effective management of ARDS in the neonatal population Keywords Acute respiratory distress syndrome[omicsonline.org]
  • Epidemiology About 1 in 20,000-30,000 newborn US infants will have RDS. Approximately half of neonates born at gestation age of 26-28 weeks will develop RDS, while about 30% of 30-31 gestation week neonates will develop it [ 4 ].[pedclerk.bsd.uchicago.edu]
Sex distribution
Age distribution

Pathophysiology

  • The pathophysiology of respiratory failure in preterm infants is characterized by a combination of primary surfactant deficiency and surfactant inactivation as a result of plasma proteins leaking into the airways from areas of epithelial disruption and[ncbi.nlm.nih.gov]
  • Meconium aspiration syndrome The pathophysiology of meconium aspiration syndrome (MAS) is characterized by a mechanical obstruction of the airways leading to an uneven ventilation and respiratory failure.[nature.com]
  • This paper reviews the pathophysiology of ARDS and the management of paediatric patients with acute lung injury.[jpnim.com]

Prevention

  • Abstract The reversal of lung collapse is one of the challenges of lung injury prevention in pediatric acute respiratory distress syndrome.[ncbi.nlm.nih.gov]
  • The best way of preventing HMD is by preventing a preterm birth.[childrenshospital.org]
  • Taking steps to prevent premature birth can help prevent neonatal RDS. Good prenatal care and regular checkups beginning as soon as a woman discovers she is pregnant can help avoid premature birth.[medlineplus.gov]
  • Prevention The vast majority of babies who develop RDS do so because they are premature. Attempts to prevent early delivery are therefore a major consideration. A number of strategies can be used.[nursingtimes.net]
  • Attention to prevention of hypoglycaemia is, however, an important part of ongoing care.[www2.health.vic.gov.au]

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