Hyaline membrane disease

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Hyaline membrane disease HYALINE MEMBRANE DISEASE: A RESPIRATORY DISEASE OF THE

Hyaline membrane disease

HYALINE MEMBRANE DISEASE: A RESPIRATORY DISEASE OF THE NEWBORN, ESPECIALLY THE

PREMATURE INFANT, IN WHICH A MEMBRANE COMPOSED OF PROTEINS AND DEAD CELLS LINES THE ALVEOLI (THE TINY AIR SACS IN THE LUNG), MAKING GAS EXCHANGE DIFFICULT OR IMPOSSIBLE. THE WORD "HYALINE" COMES FROM THE GREEK WORD "HYALOS" MEANING "GLASS OR TRANSPARENT STONE SUCH AS CRYSTAL." THE MEMBRANE IN HYALINE MEMBRANE DISEASE LOOKS GLASSY.
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Hyaline membrane disease is now commonly called respiratory distress syndrome (RDS).

Hyaline membrane disease is now commonly called respiratory distress syndrome (RDS).

It is caused by a deficiency of a molecule called surfactant.
RDS almost always occurs in newborns born before 37 weeks of gestation. The more premature the baby is, the greater is the chance of developing RDS. RDS is more likely to occur in newborns of diabetic mothers.
Surfactant, a mixture of phospholipids and lipoproteins, is secreted by lung cells. The air-fluid interface of the film of water lining the alveoli of the lung (where the exchange of oxygen and CO2 occurs) exerts large forces that cause the alveoli to close if surfactant is deficient. Lung compliance is decreased, and the work of inflating the stiff lungs is increased
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The preterm newborn is further handicapped because his or her ribs

The preterm newborn is further handicapped because his or her ribs

are more easily deformed (compliant). Breathing efforts therefore result in deep sternal (breastbone) retractions but poor air entry if the ribs are compliant compared with the lungs. This results in diffuse atelectasis (collapse of the lungs).
Rapid, labored, grunting respirations usually develop immediately or within a few hours after delivery, with retractions above and below the breastbone and flaring of the nostrils. The extent of atelectasis (lung collapse) and the severity of respiratory failure progressively worsen.
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Not all infants with RDS have signs of respiratory distress; extremely low birth weight newborns (i.e.,

Not all infants with RDS have signs of respiratory distress; extremely

low birth weight newborns (i.e., < 1000 g) may be unable to initiate respirations at birth because their lungs are so stiff; they may fail to initiate breathing in the delivery room.
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The incidence of RDS can be reduced by assessment of fetal

The incidence of RDS can be reduced by assessment of fetal

lung maturity to determine the optimal time for delivery. When a fetus must be delivered prematurely, giving betamethasone systemically to the mother for at least 24 hours before delivery induces fetal surfactant production and usually reduces the risk of RDS or decreases its severity.
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If untreated, severe RDS can result in multiple organ failure and

If untreated, severe RDS can result in multiple organ failure and

death. However, if the newborn's ventilation is adequately supported, surfactant production will begin and RDS will resolve by 4 or 5 days. Recovery is hastened by treatment with pulmonary surfactant.
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Newborn respiratory distress syndrome Newborn respiratory distress syndrome (NRDS) happens when

Newborn respiratory distress syndrome

Newborn respiratory distress syndrome (NRDS) happens when a

baby's lungs are not fully developed and cannot provide enough oxygen, causing breathing difficulties. It usually affects premature babies.
It's also known as infant respiratory distress syndrome, hyaline membrane disease or surfactant deficiency lung disease.
Despite having a similar name, NRDS is not related to acute respiratory distress syndrome (ARDS).
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Symptoms of NRDS THE SYMPTOMS OF NRDS ARE OFTEN NOTICEABLE IMMEDIATELY

Symptoms of NRDS
THE SYMPTOMS OF NRDS ARE OFTEN NOTICEABLE IMMEDIATELY AFTER BIRTH

AND GET WORSE OVER THE FOLLOWING FEW DAYS.
THEY CAN INCLUDE:
BLUE-COLOURED LIPS, FINGERS AND TOES
RAPID, SHALLOW BREATHING
FLARING NOSTRILS
A GRUNTING SOUND WHEN BREATHING
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Diagnosing NRDS A number of tests can be used to diagnose

Diagnosing NRDS
A number of tests can be used to diagnose NRDS

and rule out other possible causes.
These include:
a physical examination
blood tests to measure the amount of oxygen in the baby's blood and check for an infection
a pulse oximetry test to measure how much oxygen is in the baby's blood using a sensor attached to their fingertip, ear or toe
a chest X-ray to look for the distinctive cloudy appearance of the lungs in NRDS
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