Respiratory Distress Syndrome in the Neonate

Enormous strides have been made in understanding the pathophysiology of respiratory distress syndrome (RDS) and the role of surfactant in its cause and treatment. Nevertheless, RDS, formerly referred to as hyaline membrane disease, remains a dominant clinical problem among preterm neonates despite the introduction of pharmacologic acceleration of pulmonary maturity using antenatal corticosteroids and the development of surfactant replacement therapy in the 1990s.The incidence of complications in the survivors of RDS remains significant and continues to be differentially represented between infants of varying ancestries. These include intracranial hemorrhage, late-onset sepsis, necrotizing enterocolitis, severe retinopathy of prematurity, and bronchopulmonary dysplasia (BPD). It is often impossible to determine whether these disorders may result as the sequelae of RDS, its treatment, or the underlying prematurity. In this section, the clinical features and evaluation of infants with RDS are discussed, and therapeutic approaches other than assisted ventilation are outlined. Other recommendations and details can be found in the recent European consensus guidelines for RDS.