Which newborn should the nurse recognize as being at the greatest risk for developing respiratory distress syndrome?
IntroductionPulmonary surfactant is a complex mixture of phospholipids and proteins that creates a cohesive surface layer over the alveoli which reduces surface tension and maintains alveolar stability therefore preventing atelectasis. Show
Surfactant deficiency is a recognized cause of respiratory distress syndrome in the preterm neonate. Secondary surfactant deficiency also contributes to acute respiratory morbidity in late-preterm and term neonates with meconium aspiration syndrome, pulmonary haemorrhage, and pneumonia/sepsis. Many clinical trials have demonstrated that surfactant replacement therapy is a safe, effective and beneficial treatment as it significantly reduces respiratory morbidity (air leaks, pulmonary interstitial emphysema), ventilatory requirements and mortality in these neonates. AimThe aim of this guideline is to outline the principles of surfactant replacement therapy and the safe administration of surfactant in neonates in the Butterfly ward - Newborn Intensive Care Unit (NICU) Definition of Terms
AssessmentClinical indicationsSurfactant replacement therapy should be considered in:
Surfactant replacement therapy may be considered in:
Dosing
ManagementEquipmentPrepare equipment/supplies:
Preparation
Administration
Post-administration
Potential complications and management
Special considerations
Companion documents
Links
Evidence table The evidence table for this guideline can be viewed here. References
Please remember to read the disclaimer. The development of this nursing guideline was coordinated by Ella Eda, ANUM, Butterfly Ward, and approved by the Nursing Clinical Effectiveness Committee. Updated November 2021. Which of the following newborns would the nurse recognize as being most at risk for developing RDS?Most cases of RDS occur in babies born before 37 to 39 weeks. The more premature the baby is, the higher the chance of RDS after birth.
What is most common causes of respiratory distress syndrome in newborn?The most common etiology of neonatal respiratory distress is transient tachypnea of the newborn; this is triggered by excessive lung fluid, and symptoms usually resolve spontaneously. Respiratory distress syndrome can occur in premature infants as a result of surfactant deficiency and underdeveloped lung anatomy.
Which babies are at risk of RDS?RDS occurs most often in babies born before their due date, usually before 28 weeks of pregnancy. Less often, RDS can affect full-term newborns. Most newborns who have RDS survive. However, these babies may need extra medical care after going home.
Why premature babies have a higher risk of respiratory distress at birth?Respiratory distress syndrome (RDS) occurs in babies born early (premature) whose lungs are not fully developed. The earlier the infant is born, the more likely it is for them to have RDS and need extra oxygen and help breathing. RDS is caused by the baby not having enough surfactant in the lungs.
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