How Is Respiratory Distress Syndrome Treated?

Treatment of respiratory distress syndrome (RDS) usually begins as soon as the baby is born, sometimes in the delivery room. Most infants who show signs of RDS are quickly moved to a special intensive care unit called a neonatal intensive care unit (NICU). There they receive around-the-clock treatment from a group of health care professionals who specialize in treating premature infants.

The most important treatments for RDS are:

• Surfactant replacement therapy
• Breathing support

Surfactant Replacement Therapy

The baby is given surfactant until his or her lungs have developed enough to start making their own surfactant. Surfactant usually is given through a tube that's attached to a breathing machine. The machine pushes the surfactant directly into the baby's lungs.

Surfactant may be given right after birth in the delivery room to try to prevent or treat RDS. It can be given two to four more times over the next few days, until the baby is able to breathe on his or her own.

Breathing Support

Babies with RDS often are put on a machine that helps them breathe until their lungs have developed enough to start making their own surfactant. Until recently, these babies usually were put on a mechanical ventilator that was connected to a breathing tube that ran through the baby's mouth or nose into the windpipe.

Today, more and more babies are receiving breathing support from a nasal continuous positive airway pressure (NCPAP) machine, which pushes air into the baby's lungs through prongs in the nostrils.

Other Types of Treatment

Other treatments for babies with RDS include:

• Medicines
• Supportive therapy
• Treatment for patent ductus arteriosus, a condition that affects some premature infants

Medicines

Doctors usually give the baby antibiotics to control infections.

Supportive Therapy

Treatment in the NICU is designed to limit stress on the baby and meet his or her basic needs of warmth, nutrition, and protection. Such treatment usually includes:

• Using a radiant warmer or incubator to keep the baby warm and reduce the chances of infection.
• Ongoing monitoring of blood pressure, heart rate, breathing, and temperature through sensors taped to the baby's body.
• Using a sensor on a finger or toe to monitor the amount of oxygen in the baby's blood.
• Giving fluids and nutrients through a needle or tube inserted into a vein to prevent malnutrition and promote growth. Nutrition is critical to the growth and development of the lungs. Later, your baby may be given milk through a tube that's passed through his or her nose into the mouth.
• Monitoring fluid intake to make sure that fluid doesn't build up in the baby's lungs.