Respiratory Distress Syndrome: Signs, Causes & How To Treat

Written by Medicover Team and Medically Reviewed by Dr Alla Bhagyaraj , Pulmonologists

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Respiratory distress syndrome (RDS) is a breathing disorder that primarily affects premature newborns whose lungs are not fully developed. The condition occurs when the lungs do not produce enough surfactant, a substance that helps keep the tiny air sacs open during breathing.

Without enough surfactant, the air sacs can collapse, making it difficult for the baby to breathe and receive sufficient oxygen. Symptoms usually develop shortly after birth and require prompt medical care to support breathing and prevent complications.

What Are the Types of Respiratory Distress Syndrome?

Respiratory distress syndrome is mainly associated with newborns, although other severe respiratory conditions may also cause significant breathing difficulty.

Neonatal Respiratory Distress Syndrome

Neonatal respiratory distress syndrome, also called infant respiratory distress syndrome, primarily affects premature babies. It occurs because immature lungs do not produce enough surfactant to keep the air sacs open and functioning properly.

Acute Respiratory Distress Syndrome

Acute respiratory distress syndrome (ARDS) is a different severe lung condition that can affect children and adults. It develops when widespread lung inflammation and fluid buildup cause dangerously low blood oxygen levels.

What Are the Symptoms of Respiratory Distress Syndrome?

Symptoms of respiratory distress syndrome usually appear shortly after birth. The severity depends on the baby's gestational age, lung development, and overall health.

Rapid Breathing: The baby may breathe faster than normal as the lungs struggle to provide enough oxygen.
Chest Retractions: The skin and muscles between or below the ribs may pull inward with each breath.
Flaring Nostrils: The nostrils may widen during breathing as the baby tries to take in more air.
Grunting: A grunting sound may occur during exhalation as the baby attempts to keep the air sacs open.
Bluish Skin: The lips, fingers, or skin may appear blue or gray because of low oxygen levels.
Weakness: The baby may appear limp, unusually tired, or have a weak cry.

What Causes Respiratory Distress Syndrome?

Respiratory distress syndrome is mainly caused by insufficient surfactant production in immature lungs. Several factors can increase the likelihood that a newborn will develop the condition.

Premature Birth: Babies born before their lungs are fully developed have a higher risk of surfactant deficiency.
Surfactant Deficiency: Insufficient surfactant causes the tiny air sacs in the lungs to collapse, making breathing difficult.
Maternal Diabetes: Diabetes during pregnancy may delay fetal lung maturation.
Cesarean Delivery Without Labor: Babies delivered before labor begins may have a higher risk because hormonal changes associated with labor help prepare the lungs for breathing.
Multiple Pregnancy: Twins, triplets, and other multiple births are more likely to be premature and develop RDS.
Genetic Factors: Rare genetic conditions affecting surfactant production or function can contribute to respiratory distress.

When Should You See a Doctor for Respiratory Distress Syndrome?

Medical evaluation by a pulmonologist or Pediatrician is essential if a newborn develops rapid breathing, grunting, chest retractions, or bluish skin shortly after birth. Early assessment can identify breathing problems, measure oxygen levels, provide respiratory support, and reduce the risk of serious complications.

You should see a doctor if you have:

A newborn who is breathing unusually fast or making grunting sounds.
Persistent flaring of the nostrils or pulling in of the chest during breathing.
A premature baby showing increasing difficulty with feeding or breathing.

Get medical help immediately if:

The baby's lips, tongue, or skin appear blue or gray.
The baby has pauses in breathing or severe difficulty breathing.
The baby becomes limp, unresponsive, or has a very weak cry.

These could be signs of severe Respiratory Distress Syndrome, which needs urgent care.

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How Is Respiratory Distress Syndrome Diagnosed?

Respiratory distress syndrome is diagnosed through the baby's symptoms, physical examination, oxygen measurements, and diagnostic tests. Early diagnosis helps determine the severity of the condition and guides respiratory support.

Physical Examination

Healthcare providers assess the baby's breathing rate, chest movements, skin color, grunting, and other signs of respiratory distress.

Chest X-Ray

A chest X-ray can show characteristic changes in the lungs associated with RDS and help rule out other causes of breathing difficulty.

Arterial Blood Gas Analysis

Blood gas testing measures oxygen, carbon dioxide, and blood pH levels to determine the severity of breathing impairment.

Pulse Oximetry

Pulse oximetry is a non-invasive test that continuously monitors the baby's blood oxygen saturation.

Blood Tests

Blood tests may be performed to check for infection, assess organ function, and identify other conditions that may contribute to respiratory distress.

What Is the Treatment for Respiratory Distress Syndrome?

Treatment for respiratory distress syndrome focuses on improving oxygen levels, supporting breathing, and replacing missing surfactant. The treatment approach depends on the baby's gestational age and the severity of breathing difficulty.

Surfactant Replacement Therapy

Artificial surfactant may be delivered directly into the baby's lungs through a breathing tube. This helps keep the air sacs open and improves oxygen exchange.

Oxygen Therapy

Supplemental oxygen may be provided to maintain safe blood oxygen levels while minimizing the risks associated with excessive oxygen exposure.

Continuous Positive Airway Pressure (CPAP)

CPAP provides gentle air pressure through the nose to keep the airways and air sacs open. It is commonly used for premature babies who can breathe on their own but need additional support.

Mechanical Ventilation

Babies with severe respiratory distress may require a ventilator to assist or control breathing until their lungs can function more effectively.

Extracorporeal Membrane Oxygenation

In rare and extremely severe cases of respiratory failure, extracorporeal membrane oxygenation (ECMO) may be considered to temporarily support oxygenation and circulation.

Supportive Care

Newborns with RDS may also require careful temperature control, nutritional support, fluid management, and continuous monitoring in a neonatal intensive care unit.

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What Are the Risk Factors for Respiratory Distress Syndrome?

Several factors can increase a newborn's risk of developing respiratory distress syndrome. The greatest risk is premature birth because surfactant production increases during the later stages of pregnancy.

Premature Birth: Babies born before 37 weeks, particularly those born very early, have a higher risk.
Low Birth Weight: Smaller premature babies are more likely to have underdeveloped lungs.
Maternal Diabetes: High maternal blood sugar levels can interfere with normal lung maturation.
Cesarean Delivery Without Labor: Delivery before labor begins may increase the risk of breathing difficulties.
Multiple Births: Twins or triplets have a greater likelihood of premature delivery.
Family History: A family history of neonatal RDS may increase susceptibility.
Maternal Infections: Certain infections during pregnancy may increase the risk of premature birth and breathing complications.

What Are the Complications of Respiratory Distress Syndrome?

Severe or prolonged respiratory distress syndrome can lead to complications, particularly in very premature newborns.

Low oxygen levels affecting the brain and other organs
Air leaks from the lungs, including pneumothorax
Chronic lung disease or bronchopulmonary dysplasia
Bleeding in the brain in very premature infants
Infections and other complications related to prolonged intensive care

How Can Respiratory Distress Syndrome Be Prevented?

Not all cases of respiratory distress syndrome can be prevented, but reducing the risk of premature birth and supporting fetal lung development can lower the likelihood and severity of the condition.

Receiving regular prenatal care throughout pregnancy
Managing maternal diabetes and other pregnancy-related conditions
Preventing premature delivery whenever medically possible
Giving antenatal corticosteroids when premature birth is expected to accelerate fetal lung development
Providing appropriate care at a hospital equipped to manage premature and high-risk newborns

Frequently Asked Questions

1. What early signs should I look for with Respiratory Distress Syndrome?

Signs of Respiratory Distress Syndrome include rapid breathing, grunting, flaring nostrils, and chest retractions in infants soon after birth.

2. How should I care for myself with Respiratory Distress Syndrome-what should I do and avoid?

Follow your treatment plan, take prescribed medications, get plenty of rest, avoid smoking and secondhand smoke, and stay away from respiratory irritants like pollution.

3. Can Respiratory Distress Syndrome lead to other health issues?

Yes, Respiratory Distress Syndrome can lead to complications such as lung scarring, oxygen deprivation, and long-term respiratory problems.

4. How is Respiratory Distress Syndrome typically managed?

Respiratory Distress Syndrome is managed with oxygen therapy, mechanical ventilation, and surfactant replacement in severe cases. Close monitoring is crucial.

5. Is Respiratory Distress Syndrome likely to come back after treatment?

Respiratory Distress Syndrome is less likely to return after treatment. Prevention measures and follow-up care can help reduce the risk of recurrence.