IRDS

By Cecilia Moreno and Alana Williams

What is IRDS and who is at risk?

IRDS ,or Infant respiratory distress syndrome, is caused by deficiency of pulmonary surfactant in premature infants. Approximately one half of infants born at 28-32 weeks of gestation. Any infection may cause respiratory distress and will co-exist with iRDS

Risk Factors:


  • Family history of IRDS
  • Diabetes in the mother
  • C-section
  • premature delivery

Beware of the manifestations

Most of the time, symptoms appear within minutes of birth. Sometimes they may not appear until several hours later.

  • Apnea
  • increased WOB
  • expiratory grunting
  • Shallow breathing
  • Nasal flaring

The Complications and Pathophysiology

Chronic complications include the following:


  • Hearing impairment and visual handicap may further compromise development.
Acute complications include the following:
  • Complications related to procedures - eg, trauma to vocal cords from tracheal intubation; infection, embolism or thrombosis from venous or arterial catheterisation.
    • Alveolar rupture: pneumothorax, pneumomediastinum, pneumopericardium, interstitial emphysema.
With surfactant deficiency, a greater pressure is needed to open the alveoli. Without the necessary airway pressure, inflammation and pulmonary edema are triggered. Because blood passing through portions of lung is not oxygenated, this forms a right-to-left intrapulmonary shunt and the infant becomes hypoxemic. Lung compliance is decreased, thereby increasing the work of breathing. In severe cases, the diaphragm and intercostal muscles fatigue, and CO2retention and respiratory acidosis develop.

Thy Treatments

Giving extra surfactant to a sick infant may be helpful. Assisted breathing with a ventilator has been shown to work. A CPAP may be used to substitute assisted ventilation and extra surfactant.

Babies with RDS need close care such as:

  • Having a calm setting
  • Gentle handling
  • Staying at an ideal body temperature
  • Treating infections right away

Infant Respiratory Distress Signs