Respiratory Distress Syndrome

General Illness Information

Medical Term: Hyaline membrane disease

Common Name: Respiratory distress syndrome, neonatal RDS

Description: Respiratory distress syndrome is a special condition of the body, when the respiratory system can not provide the necessary volume of oxygen. In this case, the concentration of carbon dioxide in the blood increases significantly and can reach a critical level. This syndrome is a kind of consequence of the inferior exchange of carbon dioxide and oxygen between the circulatory system and the lungs. Note that chronic respiratory distress syndrome and acute respiratory distress syndrome may differ significantly in their manifestations.

Causes:

  • Acute disturbance of cerebral circulation;
  • Metabolic disorders: acidosis – acidification of blood in severe diseases (renal or hepatic insufficiency, poisoning); uremia – accumulation of protein decay products (urea, creatinine) in renal failure; ketoacidosis.
  • Meningitis, encephalitis – develop in infectious diseases: herpes, tick-borne encephalitis;
  • Poisoning: for example, carbon monoxide, organic solvents, drugs;
  • Oxygen starvation: breathing disorder develops as a consequence of severe oxygen starvation (for example, rescued drowning);
  • Tumors of the brain;
  • Injuries of the brain.

Diagnostics:

Analysis of complaints and anamnesis of the disease:

  • when the signs of impaired breathing (violation of rhythm and depth of breathing) appeared;
  • which event preceded the development of these disorders (head trauma, poisoning with drugs or alcohol);
  • how quickly there was a violation of breathing after a loss of consciousness;
  • Neurological examination;
  • Assessment of the frequency and depth of breathing;
  • Assessment of the level of consciousness;
  • Search for signs of brain damage (decreased muscle tone, strabismus, pathological reflexes (absent in a healthy person and appear only when the brain or spinal cord is affected);
  • Evaluation of pupils and their response to light:
    1. wide pupils that do not respond to light are characteristic for the defeat of the midbrain (the region of the brain located between the brain stem and its hemispheres);
    2. narrow (dotted) pupils, weakly reacting to light, are characteristic for damaged brain stem (the area of the brain in which vital centers are located, including the respiratory center);
  • Blood test: evaluation of the level of protein decay products (urea, creatinine), oxygen saturation of blood.
  • Acid-alkaline state of blood: checking acidification of blood;
  • Toxicological analysis: the detection of toxic agents in the blood (drugs, salts of heavy metals);
  • CT (computed tomography) and MRI (magnetic resonance imaging) of the head: allow to study the structure of the brain layer by layer, to reveal any pathological changes (tumors, hemorrhages);
  • It is also necessary to consult a neurosurgeon.

Prevention:

Prevention of breathing disorders is impossible, as this is an unpredictable complication of severe brain and whole organism diseases (craniocerebral trauma, poisoning, metabolic disorders).

Signs & Symptoms:

  • Incorrect breathing rate: breathing is either excessively rapid (it becomes superficial, that is, it has very short breaths and exhalations) or, on the contrary, it is strongly thinned (quite often it becomes very deep);
  • Violated rhythm of breathing: the time intervals between inspiration and exhalation are different, sometimes breathing can stop for a few seconds / minutes, and then reappear;
  • Lack of consciousness: not directly related to respiratory failure, but most forms of breathing disorder occur when the patient is extremely ill in an unconscious state.

Treatment:

General Measures:

Respiratory distress syndrome requires treatment:

  • Detoxification (fight against poisoning) in case of poisoning:
    1. drugs neutralizing toxins (antidotes);
    2. vitamins (groups B, C);
    3. infusion therapy (infusion of solutions intravenously);
    4. hemodialysis (artificial kidney) with uremia (accumulation of protein decay products (urea, creatinine) in renal failure);
    5. antibiotics and antiviral drugs for infectious meningitis (inflammation of the membranes of the brain);
  • The fight against brain edema (develops in the majority of severe brain diseases):
    1. diuretics;
    2. hormonal drugs (steroid hormones);
    3. preparations that improve the nutrition of the brain (neurotrophic, metabolic);
    4. timely transfer to artificial ventilation of lungs.

Possible Complications:

  • Respiratory distress syndrome is not the cause of any serious complications;
  • Oxygen starvation due to irregular breathing (if the rhythm of breathing is disturbed, the body does not receive the proper oxygen level, that is, breathing becomes “unproductive”).

Other:

Nothing Specified.

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